Organization
IHS ACQUISITION NO 139 INC
Active
Other names
Parkwood Place Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM TRYBUS (CFO)
(443) 539-2354
Entity
Organization
Contact information
Practice address
300 N BYNUM ST, LUFKIN, TX 75904-2722
(936) 637-7215
Mailing address
300 N BYNUM ST, LUFKIN, TX 75904-2722
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
112653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000644
PRIVATE PAY ID
TX
Enumeration date
10/23/2006
Last updated
12/28/2007
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