Provider Demographics
NPI:1700256443
Name:REAVIS ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:REAVIS ASSISTED LIVING LLC
Other - Org Name:ASSISTED LIVING AT TALLWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-863-4094
Mailing Address - Street 1:PO BOX 2479
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78627-2479
Mailing Address - Country:US
Mailing Address - Phone:512-863-4094
Mailing Address - Fax:512-930-9122
Practice Address - Street 1:101 TALLWOOD DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-8315
Practice Address - Country:US
Practice Address - Phone:512-948-7600
Practice Address - Fax:512-930-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139171310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility