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General NPI Number Information
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NPI Number | 1912081977
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Entity Type | Organization
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Legal Business Name | TUTOR AND ELLIS PCH
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 W AVENUE F
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City | TEMPLE
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State | TX
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Zip | 76504-5527
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Country | US
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Telephone | 254-778-1121
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Fax | 254-778-4204
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Provider Business Mailing Address
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Address Line | 300 W AVENUE F
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City | TEMPLE
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State | TX
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Zip | 76504-5527
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Country | US
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Telephone | 254-778-1121
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Fax | 254-778-4204
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Authorized Official
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Title or Position | ADMINISTRATOR/PARTNER
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Name | MS. ANNIE RUTH ELLIS
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Credential | ADMINISTRATOR/MGR
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Telephone | 254-778-1121
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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 | 115982
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License Number State | TX
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