Kilgore Al Management LLC

NPI #1346608700 in Kilgore, Texas

Provider Information

NPI Number: 1346608700
Entity Type: Organization
Organization Name: Kilgore Al Management LLC
Primary Specialty: Assisted Living Facility
Enumeration Date: Feb 1, 2016
Last Updated: Feb 1, 2016

Practice Location

Address: 2103 CHANDLER ST
City: Kilgore
State: Texas
ZIP Code: 75662-3741
Phone: (903) 984-8839

Authorized Official

Name: LAWRENCE WAYNE POWELL JR.
Title: PRESIDENT
Phone: (817) 386-8888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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