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Organization

ET TRANSITIONAL LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TROY WAYNE SIMMONS DDS (PRESIDENT)
(903) 753-7685
Entity
Organization

Contact information

Practice address
503 N 6TH ST, LONGVIEW, TX 75601-6604
(903) 753-7685
(903) 753-7686
Mailing address
503 N 6TH ST, LONGVIEW, TX 75601-6604
(903) 753-7685
(903) 753-7686

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
10/07/2014
Last updated
10/07/2014
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