Organization
DEWITT MEDICAL DISTRICT
Active
Other names
Diversicare of Luling
Organization subpart
No
Provider details
NPI number
Authorized official
ALMA ALEXANDER (AUTHORIZED REPRESENTATIVE)
(361) 275-0504
Entity
Organization
Contact information
Practice address
208 MAPLE STREET, LULING, TX 78648
(830) 875-5219
(830) 875-2919
Mailing address
208 MAPLE STREET, LULING, TX 78648
(830) 875-5219
(830) 875-2919
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001030462
—
TX
Enumeration date
06/16/2006
Last updated
04/07/2023
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