| Lubbock State Supported Living Center | |
|
3401 N University Ave Lubbock TX 79415-1734 | |
| (806) 763-7041 | |
| (806) 741-3604 |
| Full Name | Lubbock State Supported Living Center |
|---|---|
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
| Location | 3401 N University Ave, Lubbock, Texas |
| Authorized Official Name and Position | Scott Schalchlin (ASSOCIATE COMMISSIONER) |
| Authorized Official Contact | 5124383076 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lubbock State Supported Living Center Po Box 5396 Lubbock TX 79408-5396 Ph: (806) 763-7041 | Lubbock State Supported Living Center 3401 N University Ave Lubbock TX 79415-1734 Ph: (806) 763-7041 |
| NPI Number | 1649363326 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 02/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649363326 | NPI | - | NPPES |
| 000710701 | Medicaid | TX |
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