Provider Demographics
NPI:1831337039
Name:TEXAS CITY ASSISTED LIVING, LTD.
Entity type:Organization
Organization Name:TEXAS CITY ASSISTED LIVING, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-362-3506
Mailing Address - Street 1:1901 N AMBURN RD
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2488
Mailing Address - Country:US
Mailing Address - Phone:409-935-6620
Mailing Address - Fax:409-933-0658
Practice Address - Street 1:1901 N AMBURN RD
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2488
Practice Address - Country:US
Practice Address - Phone:409-935-6620
Practice Address - Fax:409-933-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124610310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility