Mabell's Place

NPI #1770770703 in Waco, Texas

Provider Information

NPI Number: 1770770703
Entity Type: Organization
Organization Name: Mabell's Place
Primary Specialty: Licensed Vocational Nurse
Enumeration Date: Oct 3, 2007
Last Updated: Oct 3, 2007

Practice Location

Address: 1115 N 12TH ST
Address 2: 1115 NORTH 12 STREET
City: Waco
State: Texas
ZIP Code: 76707-3121
Phone: (254) 752-5434

Authorized Official

Name: MISS ALICE MARIE HICKMAN, NURSE
Title: OWNER
Phone: (254) 752-5434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Licensed Vocational Nurse	164X00000X	Primary

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