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General NPI Number Information
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NPI Number | 1629613138
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Entity Type | Organization
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Legal Business Name | ALTAMONTE CARE OF BEAUMONT, LLC
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 4195 MILAM ST
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City | BEAUMONT
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State | TX
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Zip | 77707-3918
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Country | US
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Telephone | 409-842-4550
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Fax |
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Provider Business Mailing Address
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Address Line | 525 GRANT PARK CT
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City | FRANKLIN
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State | TN
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Zip | 37067-7316
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Country | US
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Telephone | 949-412-8233
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | LOGAN SEXTON
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Credential |
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Telephone | 949-412-8233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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