Organization
CLASSIC COUNTRY LIVING INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STARLETTE ROSE ROGGE (ADMINISTRATOR AND MANAGER)
(830) 336-4040
Entity
Organization
Contact information
Practice address
109 SAVANAH JON BLVD, BOERNE, TX 78015-8399
(830) 336-4040
(830) 336-4054
Mailing address
109 SAVANAH JON BLVD, BOERNE, TX 78015-8399
(830) 336-4040
(830) 336-4054
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
117205
TX
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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