Organization
SENIOR SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTI L MATTHEWS (ADMINISTRATOR)
(817) 487-5966
Entity
Organization
Contact information
Practice address
160 N RIDGEWAY DR STE 107, CLEBURNE, TX 76033-4113
(817) 487-5966
(817) 556-0394
Mailing address
PO BOX 474, CLEBURNE, TX 76033-0474
(817) 487-5966
(817) 556-0394
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/20/2007
Last updated
01/16/2015
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