Provider Demographics
NPI:1497808836
Name:HEART OF CENTRAL TEXAS INDEPENDENT LIVING CENTER, INC.
Entity Type:Organization
Organization Name:HEART OF CENTRAL TEXAS INDEPENDENT LIVING CENTER, INC.
Other - Org Name:HOCTIL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:COSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-933-7487
Mailing Address - Street 1:PO BOX 636
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-0636
Mailing Address - Country:US
Mailing Address - Phone:254-770-2350
Mailing Address - Fax:254-770-2359
Practice Address - Street 1:2005 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1968
Practice Address - Country:US
Practice Address - Phone:254-933-7487
Practice Address - Fax:254-933-7466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty