Organization
EDUCARE COMMUNITY LIVING CORPORATION - TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY A PANK (PARALEGAL)
(502) 420-2666
Entity
Organization
Contact information
Practice address
6771 CAMP BOWIE BLVD, FT WORTH, TX 76116-7112
(817) 263-8840
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10208
—
TX
01
—
679488
PTAN
—
05
—
9997
—
TX
Enumeration date
05/30/2007
Last updated
05/09/2016
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