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General NPI Number Information
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NPI Number | 1215071428
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Entity Type | Organization
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Legal Business Name | BARTON CREEK SENIOR LIVING CENTER INC.
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 2500 BARTON CREEK BLVD
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City | AUSTIN
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State | TX
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Zip | 78735-1616
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Country | US
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Telephone | 512-610-9424
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Fax | 512-610-9427
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Provider Business Mailing Address
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Address Line | 2500 BARTON CREEK BLVD
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City | AUSTIN
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State | TX
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Zip | 78735-1616
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Country | US
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Telephone | 512-610-9424
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Fax | 512-610-9427
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROSS ALAN DICKMANN
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Credential |
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Telephone | 512-610-9424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | TX
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