Organization
MASON CONVALESCENT CARE CENTER
Active
Other names
Legacy Living Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE PITA (INSURANCE/MEDICARE)
(580) 622-6300
Entity
Organization
Contact information
Practice address
110 E COLLEGE STREET, MASON, TX 76856-0107
(325) 347-6383
(325) 347-6142
Mailing address
110 E COLLEGE STREET, PO BOX 1668, MASON, TX 76856-0107
(325) 347-6383
(325) 347-6142
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
113248
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH321S
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/29/2005
Last updated
08/22/2020
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