Organization
PELICAN ASSISTED LIVING LLC
Active
Other names
Pelican Bay
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES W. MOORE SR. (PRESIDENT)
(409) 962-4450
Entity
Organization
Contact information
Practice address
2501 S MAJOR DR, BEAUMONT, TX 77707-5018
(409) 860-3500
(409) 962-9253
Mailing address
4500 MAIN AVE, GROVES, TX 77619-4712
(409) 962-4450
(409) 962-9253
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32044376872
TEXAS COMPTROLLER OF PUBLIC ACCOUNTS TAXPAYER NUMBER
TX
Enumeration date
03/09/2012
Last updated
06/20/2018
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