# THE LODGE AT ROCKY HOLLOW

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

## Provider details

- **NPI number:** 1790166502
- **Authorized official:** ANGELA HOPE PAFFE (OWNER)
- **Authorized official phone:** (254) 793-2311

## Contact information

- **Practice address:** 1650 COUNTY ROAD 245, GEORGETOWN, TX 78633-4476
- **Practice address phone:** (254) 793-2311
- **Practice address fax:** (254) 793-2554
- **Mailing address:** 1650 COUNTY ROAD 245, GEORGETOWN, TX 78633-4476
- **Mailing address phone:** (254) 793-2311
- **Mailing address fax:** (254) 793-2554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | 102467 | TX | Yes |

## Other

- **Enumeration date:** 06/17/2015
- **Last updated:** 06/17/2015