# ELCM MANOR SOUTH MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pillsbury Manor South
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447708771
- **Authorized official:** MR. PAUL BOETHEL (PRINCIPAL)
- **Authorized official phone:** (972) 728-8739

## Contact information

- **Practice address:** 20 HARBOR VIEW RD, SOUTH BURLINGTON, VT 05403-7850
- **Practice address phone:** (802) 863-7897
- **Practice address fax:** (802) 863-9728
- **Mailing address:** 14241 DALLAS PKWY STE 650, DALLAS, TX 75254-2953
- **Mailing address phone:** (214) 417-4588
- **Mailing address fax:** (214) 594-9930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | VT | Yes |

## Other

- **Enumeration date:** 09/15/2016
- **Last updated:** 09/15/2016