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General NPI Number Information
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NPI Number | 1881195386
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Entity Type | Organization
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Legal Business Name | EC OPCO LAKE JACKSON, LLC
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 206 OAK DRIVE S
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City | LAKE JACKSON
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State | TX
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Zip | 77566
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Country | US
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Telephone | 979-297-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N HURSTBOURNE PKWY SUITE 200
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City | LOUISVILLE
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State | KY
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Zip | 40222
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Country | US
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Telephone | 971-213-4234
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTIAN N. CUMMINGS
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Credential |
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Telephone | 877-483-6827
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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 |
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