Organization
LIVE OAK HOLDINGS, LLC
Active
Other names
Governor's Ridge Retirement
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN ERSELIUS (CHIEF OPERATING OFFICER)
(562) 301-9819
Entity
Organization
Contact information
Practice address
300 E DEVEREAUX ST, DECATUR, TX 76234-3033
(940) 627-1104
(940) 627-1159
Mailing address
300 E DEVEREAUX ST, DECATUR, TX 76234-3033
(940) 627-1104
(940) 627-1159
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
141222
TX
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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