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
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