Legacy Living Centers

LBN: Kilgore Manor Inc
Legacy Living Centers is an health care organization with primary practice located at 2700 S Henderson Blvd , Kilgore TX 75662-4033. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Kilgore Manor Inc can be contacted via phone (903) 984-3511, or through Pita, Janice via phone (580) 622-6300.

Contact Information

Primary practice address
2700 S Henderson Blvd Kilgore TX 75662-4033
Phone: (903) 984-3511
Fax: (903) 983-1031
Website:
Map and Directions
Authorized official contact:
Name: Pita, Janice
Phone: (580) 622-6300

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 112798 Texas

Profile Details

NPI number 1447246145
LBN Legal business name Kilgore Manor Inc
DBA Doing business as Legacy Living Centers
Authorized official Pita, Janice
Entity Organization
Organization subpart 1 No
Enumeration date Sep 27th, 2005
Last updated Aug 28th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447246145 NPPES
Texas MEDICAID 00102185
Texas Other HH2539
Texas Other 0220162-01

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