# LIVE OAK INN, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326143587
- **Authorized official:** MS. KATY C MILBERT (ADMINISTRATOR)
- **Authorized official phone:** (830) 990-4391

## Contact information

- **Practice address:** 619 W LIVE OAK ST, FREDERICKSBURG, TX 78624-4415
- **Practice address phone:** (830) 997-4391
- **Practice address fax:** (830) 990-9711
- **Mailing address:** 619 W LIVE OAK ST, FREDERICKSBURG, TX 78624-4415
- **Mailing address phone:** (830) 997-4391
- **Mailing address fax:** (830) 990-9711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 4204 | TX | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 08/22/2020