Live Oak County

Organization Active NPI Case Management Agency · Three Rivers, TX

NPI 1447445804 · NPPES record last updated Apr 4, 2023

Key facts

NPI
1447445804
Entity type
Organization (NPI type 2)
Primary specialty
Case Management Agency 251B00000X
License
001001677 (TX)
Legal business name
LIVE OAK COUNTY
Practice address
102 N Harborth Ave
Three Rivers, TX 78071
Phone
(361) 786-3820
Fax
(361) 786-3820
NPI assigned
Sep 10, 2007
Organization subpart
No

Authorized official

Name
Ida Flores
Title
Nurse
Phone
(361) 449-8019

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101029000936 TX Part B Supplier - Public Health/Welfare Agency 4284828690 Practice locations: George West, TX

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 001001677 TX Yes

Addresses

Primary practice location

102 N Harborth Ave
Three Rivers, TX 78071

Mailing address

PO Box 699
George West, TX 78022-0699
Phone (361) 449-2733

Other practice location 1

204 Bowie St.
George West, TX 78022
Phone (361) 449-8043

Other providers in Three Rivers, TX

All providers in Three Rivers, TX · Case Management Agency in Texas

Sources for this page

Verify at the official NPI Registry.