Organization
TRANSITIONAL LEARNING CENTER AT GALVESTON
Active
Other names
TideWay, Moody Neurorehabilitation Institute - Tideway
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ANDERSON (CONTRACT MANAGER)
(409) 797-1468
Entity
Organization
Contact information
Practice address
6444 CENTRAL CITY BLVD, GALVESTON, TX 77551-2058
(409) 741-3266
Mailing address
1528 POSTOFFICE STREET, GALVESTON, TX 77550-4833
(409) 797-1468
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
310400000X
Assisted Living Facility
Primary
134987
TX
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148770
TEXAS HEALTH & HUMAN SERVICES ASSISTED LIVING FACILITY LICENSE
TX
01
—
150157
TEXAS HEALTH & HUMAN SERVICES ASSISTED LIVING FACILITY LICENSE
TX
Enumeration date
08/02/2013
Last updated
12/09/2019
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