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Organization
ELCM MANOR SOUTH MANAGEMENT LLC
Active
Organization
ELCM MANOR SOUTH MANAGEMENT LLC
Active
Other names
Pillsbury Manor South
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL BOETHEL (PRINCIPAL)
(972) 728-8739
Entity
Organization
Contact information
Practice address
20 HARBOR VIEW RD, SOUTH BURLINGTON, VT 05403-7850
(802) 863-7897
(802) 863-9728
Mailing address
14241 DALLAS PKWY STE 650, DALLAS, TX 75254-2953
(214) 417-4588
(214) 594-9930
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
VT
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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