Organization
MY BEACH HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENNA JO DECKER LVN (MANAGER)
(940) 889-4911
Entity
Organization
Contact information
Practice address
508 S DONALD ST, SEYMOUR, TX 76380-2812
(940) 889-4911
(940) 889-4912
Mailing address
508 S DONALD ST, SEYMOUR, TX 76380-2812
(940) 889-4911
(940) 889-4912
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
113832
TX
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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