Organization
GOLDEN TRIANGLE LIVING CENTER
Active
Other names
Woodlea Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E RICHARDSON (CEO)
(318) 445-6470
Entity
Organization
Contact information
Practice address
101 OGLESBEE RD, SILSBEE, TX 77656-5925
(409) 385-5807
(318) 641-3717
Mailing address
2750 S 4TH ST, BEAUMONT, TX 77701-7912
(409) 832-4112
(318) 641-3717
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000I8H4S
—
TX
Enumeration date
03/17/2010
Last updated
03/17/2010
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