Organization
EDUCARE COMMUNITY LIVING CORPORATION - TEXAS
Active
Other names
Longview CLASS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA G. OMBRES (ASSOC. GEN. COUNSEL/PRIVACY OFFICER)
(502) 394-2100
Entity
Organization
Contact information
Practice address
1705 JUDSON RD, SUITE 103B, LONGVIEW, TX 75601-2938
(903) 753-8063
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011962
VENDOR NO.
TX
Enumeration date
06/06/2013
Last updated
06/06/2013
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