Denton IV Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DENTON IV ENTERPRISES, LLC

Doing business as

Vintage Assisted Living of Denton

Practice address

205 N Bonnie Brae St
Denton, TX 76201-3766

Phone

(940) 373-4766

NPI assigned

Oct 16, 2023

Last updated

Oct 31, 2023By 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

Mr. Gary Blake

Title

Managing Member

Phone

(817) 348-8959

Specialties & licenses 1

Addresses

Other names 1

• Vintage Assisted Living of Denton Doing business as

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1033991013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ STE 600",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094831",
            "telephone_number": "817-348-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BONNIE BRAE ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013766",
            "telephone_number": "940-373-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTON IV ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8959",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage Assisted Living of Denton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Denton, TX
• Providers in Denton, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.