Organization
EDUCARE COMMUNITY LIVING CORPORATION - GULF COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
901 S MO PAC EXPY, BLDG II SUITE 450, AUSTIN, TX 78746-5776
(512) 498-2705
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007256
—
TX
05
—
1010279
—
TX
05
—
611700
—
TX
Enumeration date
05/30/2007
Last updated
12/18/2007
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