Organization
PM MANAGEMENT-SAN ANGELO NC I LLC
Active
Other names
Trisun Care Center-Meadow Creek
Organization subpart
No
Provider details
NPI number
Authorized official
LEW N LITTLE JR. (CEO)
(512) 634-4900
Entity
Organization
Contact information
Practice address
4343 OAK GROVE BLVD, SAN ANGELO, TX 76904-4550
(325) 949-2559
(325) 949-3598
Mailing address
1703 W. FIFTH ST, SUITE 700, AUSTIN, TX 78703
(512) 634-4900
(512) 634-4950
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
128894
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000170
FACILITY ID NO.
TX
05
—
001018223
—
TX
Enumeration date
12/11/2006
Last updated
08/31/2011
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