Organization
TRACY'S COUNTRY LIVING
Active
Organization
TRACY'S COUNTRY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL B TRACY (OWNER)
(830) 665-5049
Entity
Organization
Contact information
Practice address
139 PR 6623 PO 96, DEVINE, TX 78016-0096
(830) 665-5049
(830) 665-5049
Mailing address
139PR 6623, DEVINE, TX 78016-0096
(830) 665-5049
(830) 665-5049
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000675800
PROVIDER ID
TX
Enumeration date
11/17/2006
Last updated
06/17/2008
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