Basic Information
| Provider Information | |||||||||
| NPI: | 1386213197 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CARADAY LAMPASAS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 THORPE LN STE 105-143 | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786667105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5126418805 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 E AVE J | ||||||||
| Address2: | |||||||||
| City: | LAMPASAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765501211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125566267 | ||||||||
| FaxNumber: | 5125566601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2021 | ||||||||
| LastUpdateDate: | 06/24/2021 | ||||||||
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| AuthorizedOfficialLastName: | MOORE | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5126418805 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.