Organization
GENERATION GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRA E COKLEY OWNER (ADMINISTRATION)
(512) 926-6813
Entity
Organization
Contact information
Practice address
5605 BERKMAN DR, AUSTIN, TX 78723-2622
(512) 926-6813
(512) 926-3730
Mailing address
5605 BERKMAN DR, AUSTIN, TX 78723-2622
(512) 926-6813
(512) 926-3730
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
050603
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001002999
—
TX
Enumeration date
03/06/2007
Last updated
07/16/2008
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