Leonard Manor Inc

Organization Active NPI Nursing Facility/Intermediate Care Facility · Leonard, TX

NPI 1679569370 · NPPES record last updated Aug 28, 2008

Key facts

NPI
1679569370
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
112350 (TX)
Legal business name
LEONARD MANOR INC
Practice address
902 E Hackberry St
Leonard, TX 75452-6318
Phone
(903) 587-2282
Fax
(903) 587-2594
NPI assigned
Sep 27, 2005
Organization subpart
No

Authorized official

Name
Mrs. Janice Pita
Title
Insurance/Medicare
Phone
(580) 622-6300

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 112350 TX Yes

Addresses

Primary practice location

902 E Hackberry St
Leonard, TX 75452-6318

Mailing address

902 E Hackberry St
Leonard, TX 75452-6318
Phone (903) 587-2282

Other identifiers

IdentifierTypeStateIssuer
001012164MedicaidTX
1893166-01OtherTXTEXAS MEDICAID PART B
HH322SOtherTXBLUE CROSS BLUE SHIELD TX

Other names

  • Legacy Living Centers Doing business as

Other providers in Leonard, TX

All providers in Leonard, TX · Nursing Facility/Intermediate Care Facility in Texas

Sources for this page

Verify at the official NPI Registry.