Shady Lane Community Residence
Intermediate care facility for individuals with intellectual disabilities in La Grange, TX, Medicare certification number 45G398.
Medicare certification
Provider of Services- CCN
- 45G398
- Status
- Active
- Provider type
- Intermediate care facility for individuals with intellectual disabilities
- Control type
- Private (non-profit)
- Participating since
- Jul 2, 1990
- Last certification
- Jan 24, 2025
- Beds
- 6
- Most recent change of ownership
- Mar 15, 2012
- Address
- 542 East Pecan Street
La Grange, TX 78945
(979) 968-8820
NPI records for this facility (CCN to NPI Mapping) 1
-
dba Kenmar Residential Services
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- La Grange, TX
- NPI 1932268554
Name & address match
Other intermediate care facilities for individuals with intellectual disabilities in La Grange, TX
Sources for this page
- Provider of Services: the certification, provider type, beds and status.
- Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
- NPPES NPI Registry: the NPI records connected to this certification.