Healthcare Provider Details

I. General information

NPI: 1497808836
Provider Name (Legal Business Name): HEART OF CENTRAL TEXAS INDEPENDENT LIVING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5709 S 31ST ST STE 110
TEMPLE TX
76502-4464
US

IV. Provider business mailing address

PO BOX 636
BELTON TX
76513-0636
US

V. Phone/Fax

Practice location:
  • Phone: 254-933-7487
  • Fax: 254-933-7466
Mailing address:
  • Phone: 254-933-7487
  • Fax: 254-933-7466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MELISSA INGRIOLA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 254-933-7487