Organization
PECAN RIDGE LIVING CENTER LTD
Active
Parent organization
SURREY HOLDINGS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SURREY HOLDINGS, INC
Authorized official
MIKE HAWKER (CFO)
(210) 340-7155
Entity
Organization
Contact information
Practice address
1916 SELEY AVE, WACO, TX 76704-2057
(254) 799-6291
(254) 799-5340
Mailing address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 340-7155
(210) 340-4832
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
003799
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012117
—
TX
Enumeration date
11/01/2005
Last updated
06/17/2008
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