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General NPI Number Information
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NPI Number | 1700951449
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Entity Type | Organization
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Legal Business Name | LIVING RESOURCES LLC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 301 W AVENUE D
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City | SWEETWATER
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State | TX
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Zip | 79556-5133
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Country | US
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Telephone | 325-235-2568
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Fax |
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Provider Business Mailing Address
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Address Line | 3125 S 27TH ST
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City | ABILENE
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State | TX
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Zip | 79605-6239
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Country | US
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Telephone | 325-695-2112
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Fax | 325-794-0023
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | GLEN SHELTON
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Credential |
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Telephone | 325-695-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 001001878
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 001001879
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License Number State | TX
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