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General NPI Number Information
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NPI Number | 1003148115
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Entity Type | Organization
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Legal Business Name | PALOMAS COVE LLC
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 521 WOODHAVEN
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City | INGLESIDE
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State | TX
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Zip | 78362-4678
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Country | US
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Telephone | 361-523-8241
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | INGLESIDE
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State | TX
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Zip | 78362-1267
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Country | US
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Telephone | 361-523-8241
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Fax |
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MRS. JENNIFER JONES BECK
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Credential | MSW, LCSW
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Telephone | 361-523-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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