| Organization Name: | TRACY'S COUNTRY LIVING |
| NPI Number: | 1083788517 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROL B TRACY (OWNER) |
| Mailing Address: | 139 Pr 6623 Po 96 Devine |
| State: | TX US |
| Postal Code: | 780160096 |
| Phone Number: | 8306655049 |
| Fax Number: | 8306655049 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3747A0650X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Nursing Service Related Providers |
| Taxonomy Classification: | Technician |
| Taxonomy Specialization: | Attendant Care Provider |
| Taxonomy Definition: | An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |