Organization
COUNTRY HOME ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FORTUNE A VARDEMAN (OWNER)
(830) 420-2273
Entity
Organization
Contact information
Practice address
1311 LOWER SEGUIN RD, MARION, TX 78124-4004
(830) 420-2273
Mailing address
1311 LOWER SEGUIN RD, MARION, TX 78124-4004
(830) 420-2273
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
121696
TX
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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