Organization
CHAVEZ PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY A CHAVEZ (OWNER)
(510) 828-0828
Entity
Organization
Contact information
Practice address
4605 MEMORIAL DR, WACO, TX 76711-1360
(510) 828-0828
(254) 946-0900
Mailing address
PO BOX 154846, WACO, TX 76715-4846
(510) 828-0828
(254) 946-0900
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
124013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016253
—
TX
Enumeration date
08/12/2008
Last updated
08/12/2008
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