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General NPI Number Information
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NPI Number | 1821084138
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Entity Type | Organization
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Legal Business Name | LIVINGSTON HEALTH CARE CENTER LTD. CO.
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 12/19/2008
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Provider Practice Location Address
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Address Line | 301 WEST PARK DRIVE
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City | LIVINGSTON
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State | TX
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Zip | 77351-8151
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Country | US
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Telephone | 936-327-4341
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Fax | 936-327-6277
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Provider Business Mailing Address
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Address Line | 2537 GOLDEN BEAR DR
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City | DALLAS
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State | TX
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Zip | 75006-2377
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Country | US
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Telephone | 214-954-4114
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Fax | 214-871-3057
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Authorized Official
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Title or Position | CHIEF EXECUTIVE
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Name | MRS. ROBIN UNDERHILL
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Credential |
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Telephone | 214-954-4114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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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 | 114558
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License Number State | TX
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