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General NPI Number Information
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NPI Number | 1275524027
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Entity Type | Organization
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Legal Business Name | CARILLON, INC.
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 1717 NORFOLK AVE
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City | LUBBOCK
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State | TX
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Zip | 79416
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Country | US
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Telephone | 806-281-6000
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Fax | 806-281-6041
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Provider Business Mailing Address
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Address Line | 1717 NORFOLK AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-6099
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Country | US
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Telephone | 806-281-6000
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Fax | 806-281-6041
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Authorized Official
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Title or Position | CHAIR
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Name | MR. JOHN JACKSON MCCLENDON
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Credential |
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Telephone | 806-763-9561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 103309
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 148539
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 146447
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 145619
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License Number State | TX
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