Pecan Ridge Living Center Ltd

LBN: Pecan Ridge Living Center Ltd
Pecan Ridge Living Center Ltd is an health care organization with primary practice located at 1916 Seley Ave , Waco TX 76704-2057. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness, which is considered as the primary health care specialty. Pecan Ridge Living Center Ltd can be contacted via phone (254) 799-6291, or through Hawker, Mike via phone (210) 340-7155.

Contact Information

Primary practice address
1916 Seley Ave Waco TX 76704-2057
Phone: (254) 799-6291
Fax: (254) 799-5340
Website:
Map and Directions
Authorized official contact:
Name: Hawker, Mike
Phone: (210) 340-7155

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness 310500000X 003799 Texas

Profile Details

NPI number 1891786638
LBN Legal business name Pecan Ridge Living Center Ltd
DBA Doing business as
Authorized official Hawker, Mike
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 1st, 2005
Last updated Jun 17th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891786638 NPPES
Texas MEDICAID 001012117

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