Organization
ENCHANTED PINES, INC.
Active
Other names
Enchanted Pines
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHERINE MCCALL (ADMINISTRATOR)
(936) 545-6889
Entity
Organization
Contact information
Practice address
1154 E LOOP 304, CROCKETT, TX 75835-1810
(936) 544-5065
(936) 546-2694
Mailing address
1154 E LOOP 304, CROCKETT, TX 75835-1810
(936) 544-5065
(936) 546-5674
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000617
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004039
—
TX
05
—
001004040
—
TX
Enumeration date
08/28/2007
Last updated
11/03/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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