Organization
COMMUNITY LIVING CONCEPTS, INC
Active
Organization
COMMUNITY LIVING CONCEPTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE HANNAH (CEO)
(817) 558-9559
Entity
Organization
Contact information
Practice address
110 EAST WALNUT ST, KEENE, TX 76059
(817) 558-9559
(817) 928-1676
Mailing address
110 EAST WALNUT ST, KEENE, TX 76059
(817) 558-9559
(817) 928-1676
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
12/27/2006
Last updated
10/03/2023
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