Organization
CROCKETT SENIOR CARE, LLC
Active
Other names
PITTSBURG NURSING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JACK COOK (MEMBER)
(254) 399-6788
Entity
Organization
Contact information
Practice address
200 W STATE HWY 6, SUITE 612, WACO, TX 76712
(254) 399-6788
(254) 399-6766
Mailing address
200 W STATE HIGHWAY 6, SUITE 612, WACO, TX 76712-7923
(254) 399-6788
(254) 399-6766
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021232
—
TX
Enumeration date
05/15/2013
Last updated
04/14/2015
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