Organization · NPI-2

Land Manor, INC.

Clinic/Center, Rehabilitation, Substance Use Disorder · Beaumont, TX

NPI number1083838585
StatusActive
Last updated in NPPESNov 30, 2009

Details

NPI
1083838585
Entity type
Organization (NPI-2)
Legal business name
Land Manor, INC.
Organization subpart
No
Enumeration date
Apr 13, 2007
Last updated
Nov 30, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder124-124HTXYes
324500000X Substance Abuse Rehabilitation Facility124-FTX

Practice location

355 N 18th St
Suite 101
Beaumont, TX 77707-2229

Phone 409-838-3946 · Fax 409-838-4298

Mailing address

Po Box 7250
Beaumont, TX 77726-7250

Phone 409-838-3946 · Fax 409-838-4298

Authorized official

Cheryl Ann Kahclamat
Quality Management Director
4098383946

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