Diversicare Normandy Terrace LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

117387 Issued in TX

Legal business name

DIVERSICARE NORMANDY TERRACE LLC

Practice address

841 Rice Rd
San Antonio, TX 78220-3513

Phone

(210) 648-0101

Fax

(210) 648-2252

NPI assigned

Jul 13, 2007

Organization subpart

Yes

Parent organization

ADVOCAT INC.As reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Normandy Terrace Healthcare and Rehabilitation Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Diversicare Leasing LP

  • Skilled Nursing Facility
  • Martin, TN
  • NPI 1538157664

  Member Of

  NPD member

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1083813588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 RICE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782203513",
            "telephone_number": "210-648-0101",
            "fax_number": "210-648-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 RICE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782203513",
            "telephone_number": "210-648-0101",
            "fax_number": "210-648-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE NORMANDY TERRACE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCAT INC.",
        "enumeration_date": "2007-07-13",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "117387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SNF",
            "identifier": "67-5823",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Normandy Terrace Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Theresa Ann Dissette
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• Sue Ann Dittrich
• Diverse Speech Therapy Solutions, LLC
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• Diversity Holdings LLC
• Casey Ryan Divin
• Divine Youth Guidance LLC
• Erica Divine, LPC
• Divinity Caregivers LLC

• Skilled Nursing Facility in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.