Organization · Type 2 NPI
James W Wallace dba Southern Wind Manor
Assisted Living Facility · Pittsburg, TX
NPI number
1407997380
Active
Practice location
618 Quitman St
Pittsburg, TX 75686-1086
Fax (903) 855-1585
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility Primary | 310400000X | 118382 (TX) |
Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
About NPI 1407997380
James W Wallace dba Southern Wind Manor's National Provider Identifier is 1407997380, issued on Feb 12, 2007. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Pittsburg, TX. The record was last updated on Aug 22, 2020.