Organization
CROSBY COMMUNITY HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD WAYNE PECOT (PRESIDENT)
(903) 295-7391
Entity
Organization
Contact information
Practice address
112 S WARD DR, LONGVIEW, TX 75604
(903) 295-7391
(903) 295-7395
Mailing address
112 S WARD DR, LONGVIEW, TX 75604
(903) 295-7391
(903) 295-7395
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0000753901
TX
Other
Enumeration date
05/23/2006
Last updated
08/22/2020
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