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Organization
CROCKETT SENIOR CARE, LLC
Active
Organization
CROCKETT SENIOR CARE, LLC
Active
Other names
PITTSBURG NURSING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JACK COOK (MEMBER)
(254) 399-6788
Entity
Organization
Contact information
Practice address
200 W STATE HWY 6, SUITE 612, WACO, TX 76712
(254) 399-6788
(254) 399-6766
Mailing address
200 W STATE HIGHWAY 6, SUITE 612, WACO, TX 76712-7923
(254) 399-6788
(254) 399-6766
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021232
—
TX
Enumeration date
05/15/2013
Last updated
04/14/2015
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