Organization
DAVENPORT RESIDENTIAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY ANN DAVENPORT (ADMINISTRATOR)
(254) 344-2260
Entity
Organization
Contact information
Practice address
1649 LCR 310, MART, TX 76664-5207
(254) 344-2260
(245) 344-2472
Mailing address
1649 LCR 310, MART, TX 76664-5207
(254) 344-2260
(245) 344-2472
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001016443
—
TX
Enumeration date
11/07/2008
Last updated
11/07/2008
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