Provider Demographics
NPI:1215407739
Name:TEXAS LOVING CARE SENIOR LIVING
Entity Type:Organization
Organization Name:TEXAS LOVING CARE SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCWHORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-662-4010
Mailing Address - Street 1:200 N TAMMYE LN
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77864-3008
Mailing Address - Country:US
Mailing Address - Phone:936-348-2413
Mailing Address - Fax:
Practice Address - Street 1:200 N TAMMYE LN
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TX
Practice Address - Zip Code:77864-3008
Practice Address - Country:US
Practice Address - Phone:936-348-2413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
00Other00