Advanced Living Technologies Inc

Organization Active NPI Pediatric Skilled Nursing Facility · Giddings, TX

NPI 1962626432 · NPPES record last updated Nov 2, 2012

Key facts

NPI
1962626432
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Skilled Nursing Facility 3140N1450X
License
117933 (TX)
Legal business name
ADVANCED LIVING TECHNOLOGIES INC
Practice address
1181 N Williamson St
Giddings, TX 78942-1213
Phone
(979) 542-3611
Fax
(979) 542-1365
NPI assigned
Apr 13, 2007
Organization subpart
No

Authorized official

Name
Mr. Paul Gray
Title
President
Phone
(512) 345-0700

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X 117933 TX Yes

Addresses

Primary practice location

1181 N Williamson St
Giddings, TX 78942-1213

Mailing address

10415 Morado Cir
Suite 3 120
Austin, TX 78759-5696
Phone (512) 345-0700

Other identifiers

IdentifierTypeStateIssuer
000477503MedicaidTX

Other names

  • COUNTRY CAREPLEX Doing business as

Other providers in Giddings, TX

All providers in Giddings, TX · Pediatric Skilled Nursing Facility in Texas

Sources for this page

Verify at the official NPI Registry.