Organization
EDUCARE COMMUNITY LIVING CORPORATION - TEXAS
Active
Other names
San Angelo ICF
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA G. OMBRES (ASSOC. GEN. COUNSEL/PRIVACY OFFICER)
(502) 394-2100
Entity
Organization
Contact information
Practice address
701 E 19TH ST, SAN ANGELO, TX 76903-3518
(325) 659-6682
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003748
VENDOR NO.
TX
Enumeration date
06/06/2013
Last updated
06/10/2013
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