NPIMap

Organization Active NPI

Jefferson County Adult Day Center

  • Custodial Care Facility
  • Port Arthur, TX
National Provider Identifier
1083945810
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
Legal business name
JEFFERSON COUNTY ADULT DAY CENTER
Practice address
603 5TH St
Port Arthur, TX 77640-6540
Phone
(409) 549-6260
NPI assigned
Jan 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
Ms. Schwanna K. Johnson, RN
Title
Director
Phone
(409) 225-6475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X Primary

Addresses

Primary practice location

603 5TH St
Port Arthur, TX 77640-6540

Mailing address

236 Dryden PL
Port Arthur, TX 77642-8315
Phone (409) 549-6260

National Provider Directory

National Provider Directory
Tax ID family
Jefferson County Adult Day Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

603 5th St
Port Arthur, TX 77640
Phone (409) 549-6260

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1083945810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 DRYDEN PL",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428315",
            "telephone_number": "409-549-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 5TH ST",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776406540",
            "telephone_number": "409-549-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY ADULT DAY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SCHWANNA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "409-225-6475",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.