Conroe WM LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CONROE WM LLC

Doing business as

Worthington Manor

Practice address

5416 W. Davis St.
Conroe, TX 77304

Phone

(971) 233-2836

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By 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

Norma Upshur

Title

Manager

Phone

(901) 202-6992

Specialties & licenses 1

Addresses

Other names 1

• Worthington Manor Doing business as

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1083373922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 W. DAVIS ST.",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "971-233-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 W. DAVIS ST.",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "971-233-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE WM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "UPSHUR",
        "authorized_official_first_name": "NORMA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "901-202-6992"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Worthington Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Conroe, TX
• Providers in Conroe, 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 Dec 8, 2021; 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.