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Organization

ELCM MANOR SOUTH MANAGEMENT LLC

Active
Other names
Pillsbury Manor South
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL BOETHEL (PRINCIPAL)
(972) 728-8739
Entity
Organization

Contact information

Practice address
20 HARBOR VIEW RD, SOUTH BURLINGTON, VT 05403-7850
(802) 863-7897
(802) 863-9728
Mailing address
14241 DALLAS PKWY STE 650, DALLAS, TX 75254-2953
(214) 417-4588
(214) 594-9930

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
VT

Other

Enumeration date
09/15/2016
Last updated
09/15/2016
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