NPI 1346608700

Kilgore Al Management LLC

Organisation Assisted Living Facility Kilgore, TX

Practice location

Address: 2103 Chandler St, Kilgore, TX 75662-3741
Phone: (903) 984-8839
Mailing address: 3973 W Vickery Blvd, Fort Worth, TX 76107-6492

Authorised official

Name: Lawrence Wayne Powell
Title: President
Phone: (817) 386-8888

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 103201 (TX)

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Registry record

NPI: 1346608700
Entity type: Organization
NPI issued: 1 Feb 2016
Record last updated: 1 Feb 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.