Organization
RED BEARD LLC
Active
Other names
Country Manor Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA JOHNSON (OWNER/MANAGER)
(936) 776-0703
Entity
Organization
Contact information
Practice address
265 COUNTY ROAD 613, DAYTON, TX 77535
(936) 258-6803
Mailing address
265 COUNTY ROAD 613, DAYTON, TX 77535-4325
(936) 258-6803
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310400000X
TEXAS DEPARTMENT OF AGING
TX
Enumeration date
06/08/2017
Last updated
07/21/2022
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