Organization
CRESTVIEW HH OPCO LLC
Active
Other names
Crestview Healthcare Residence
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LITTLE (MANAGER)
(512) 520-7320
Entity
Organization
Contact information
Practice address
1400 LAKE SHORE DR, WACO, TX 76708-3718
(254) 753-0291
Mailing address
1400 LAKE SHORE DR, WACO, TX 76708-3718
(254) 753-0291
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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