Organization
RUSTIC TRAILS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BUMPASS (PRESIDENT)
(254) 399-6788
Entity
Organization
Contact information
Practice address
200 W HIGHWAY 6, SUITE 509, WACO, TX 76712-7923
(254) 399-6788
(254) 399-6766
Mailing address
200 W HIGHWAY 6, SUITE 509, WACO, TX 76712-7923
(254) 399-6788
(254) 399-6766
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
TX
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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