Organization
JAMES E. RYAN
Active
Other names
Agnes Dent Homes III
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ERICH RYAN (ADMINISTRATOR/SOLE PROPRIETOR)
(806) 797-9859
Entity
Organization
Contact information
Practice address
5322 22ND ST, LUBBOCK, TX 79407-2117
(806) 797-9859
(806) 785-3289
Mailing address
5280 MARSHA SHARP FWY, LUBBOCK, TX 79407-3524
(806) 797-9859
(806) 785-3289
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/21/2012
Last updated
08/16/2012
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