NPIMap

Organization Active NPI

New Haven Assisted Living and Memory Care

  • Assisted Living Facility
  • Schertz, TX
National Provider Identifier
1003205618
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
105480 Issued in TX
Legal business name
NEW HAVEN ASSISTED LIVING AND MEMORY CARE
Practice address
2300 FM 3009
Schertz, TX 78154-2785
Phone
(210) 319-4965
Fax
(210) 319-4947
NPI assigned
Jan 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Nicholls
Title
Regional President
Phone
(847) 975-1609

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 105480 TX Primary
Alzheimer Center (Dementia Center) 311500000X 105481 TX

Addresses

Primary practice location

2300 FM 3009
Schertz, TX 78154-2785

Mailing address

2300 FM 3009
Schertz, TX 78154-2785
Phone (210) 319-4965

Other names 1

  • 65 Alive, LLC Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1003205618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 FM 3009",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781542785",
            "telephone_number": "210-319-4965",
            "fax_number": "210-319-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 FM 3009",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781542785",
            "telephone_number": "210-319-4965",
            "fax_number": "210-319-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN ASSISTED LIVING AND MEMORY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "NICHOLLS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "REGIONAL PRESIDENT",
        "authorized_official_telephone_number": "847-975-1609"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "105480",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "TX",
            "license": "105481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "65 Alive, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Schertz, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.