Organization
LAKEPORT LODGE OF LOVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DORCAS MARIA DUNLAP-BROWN (PROGRAM MANAGER)
(903) 702-3616
Entity
Organization
Contact information
Practice address
11585 FM 349, A, LONGVIEW, TX 75603-7562
(903) 702-3616
Mailing address
11585 FM 349, A, LONGVIEW, TX 75603-7562
(903) 702-3616
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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