Provider First Line Business Practice Location Address: 
3201 S WATER ST
    Provider Second Line Business Practice Location Address: 
SETON HIGHLAND LAKES CARE-A-VAN
    Provider Business Practice Location Address City Name: 
BURNET
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
78611-4510
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
830-596-3081
    Provider Business Practice Location Address Fax Number: 
512-756-6405
    Provider Enumeration Date: 
12/05/2006