| NPI | 1225019755 |
|---|---|
| Doing Business As | PINE SHADOW RETREAT |
| Entity Type | Organization |
| Authorized Contact | BETTY LEWIS SWABADO Assistant Administrator 281-354-2155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: TX DME00G318) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TX 000448902) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: 1072420001) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2025-09-11 |