Cold Water Creek Residential LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

COLD WATER CREEK RESIDENTIAL LLC

Doing business as

CARING HEARTS OF ARLINGTON

Practice address

1610 Mt Zion Dr
Arlington, TX 76018-3090

Phone

(214) 226-4037

Fax

(817) 763-0315

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Mazvita Matselele

Title

Owner

Phone

(214) 226-4037

Specialties & licenses 1

Addresses

Other names 1

• CARING HEARTS OF ARLINGTON Doing business as

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1013268838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MT ZION DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760183090",
            "telephone_number": "214-226-4037",
            "fax_number": "817-763-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MT ZION DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760183090",
            "telephone_number": "214-226-4037",
            "fax_number": "817-763-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLD WATER CREEK RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "MATSELELE",
        "authorized_official_first_name": "MAZVITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-226-4037"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARING HEARTS OF ARLINGTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Arlington, TX
• Providers in Arlington, TX by specialty
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.