Organization
MIRACLE VALLY ASSISTING LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTRA M BUCKLEY (VICE PRESIDENT)
(469) 865-3132
Entity
Organization
Contact information
Practice address
800 E 3RD AVE, CORSICANA, TX 75110-4715
(469) 865-3132
Mailing address
800 E 3RD AVE, CORSICANA, TX 75110-4715
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
TX
Other
Enumeration date
11/07/2011
Last updated
11/07/2011
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