Organization
EDUCARE COMMUNITY LIVING LIMITED PARTNERSHIP
Active
Other names
MTX CLARA COTTAGE
Organization subpart
No
Provider details
NPI number
Authorized official
DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
621 W CLARA AVE, IOWA PARK, TX 76367-1241
(817) 293-7575
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001000299
—
TX
Enumeration date
03/31/2007
Last updated
07/31/2008
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