NPI 1891817094

Country Place Village I LP

Organisation Assisted Living Facility Kilgore, TX

Practice location

Address: 2103 Chandler St, Kilgore, TX 75662-3741
Phone: (903) 984-7827
Mailing address: PO Box 479, Tyler, TX 75710-0479

Authorised official

Name: Brian K Clarke
Title: President Ceo
Phone: (903) 566-8500

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 100561 (TX)

Other Assisted Living Facility providers in Texas →

Registry record

NPI: 1891817094
Entity type: Organization
NPI issued: 6 Apr 2007
Record last updated: 22 Aug 2020

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.