Jude's Place LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

JUDE'S PLACE LLC

Practice address

13537 Lost Spurs Rd
Roanoke, TX 76262-4508

Phone

(817) 266-9626

NPI assigned

Oct 13, 2016

Last updated

Oct 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Celeste J Kelly, ACHE, BSCSM

Title

Director, Case Manager

Phone

(817) 266-9626

Specialties & licenses 2

Addresses

Other names 1

• Jude's Place Care Management Other name

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1013467000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13537 LOST SPURS RD",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762624508",
            "telephone_number": "817-266-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13537 LOST SPURS RD",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762624508",
            "telephone_number": "817-266-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDE'S PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR, CASE MANAGER",
        "authorized_official_telephone_number": "817-266-9626",
        "authorized_official_credential": "ACHE, BSCSM"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jude's Place Care Management",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Case Management Agency in Roanoke, TX
• Providers in Roanoke, TX by specialty
• Case Management Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.