Organization
INDEPENDENT LIVING OF TEXARKANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAGIE PINTER (MEMBER)
(903) 831-3911
Entity
Organization
Contact information
Practice address
3120 SMITH ST, TEXARKANA, TX 75501-4083
(903) 831-3911
(903) 831-4195
Mailing address
3120 SMITH ST, TEXARKANA, TX 75501-4083
(903) 831-3911
(903) 831-4195
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
118529
TX
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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