Active NPI
Seasons Assisted Living, LLC
- Assisted Living Facility
- Conroe, TX
National Provider Identifier
1093477697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- SEASONS ASSISTED LIVING, LLC
- Practice address
- 1 Briarwood Dr
Conroe, TX 77301-1964 - Phone
- (936) 274-3177
- Fax
- (936) 249-6486
- NPI assigned
- Oct 11, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shawn Medlin
- Title
- Ceo
- Phone
- (936) 274-3177
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary | ||
| Alzheimer Center (Dementia Center) | 311500000X |
Addresses
Primary practice location
1 Briarwood Dr
Conroe, TX 77301-1964
Mailing address
12542 Savage CT
Magnolia, TX 77354-3636
Phone (936) 274-3177
Other practice location 1
1103 Water St
Navasota, TX 77868-3174
Phone (936) 825-2237
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110211 | Other | TX | HHSC FACILITY ID # |
| 146856 | Other | TX | HHSC LICENSE # |
| 307467 | Other | TX | HHSC LICENSE # |
| 104330 | Other | TX | HHSC FACILITY ID# |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633910400000",
"number": "1093477697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12542 SAVAGE CT",
"city": "MAGNOLIA",
"state": "TX",
"postal_code": "773543636",
"telephone_number": "936-274-3177",
"fax_number": "936-249-6486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BRIARWOOD DR",
"city": "CONROE",
"state": "TX",
"postal_code": "773011964",
"telephone_number": "936-274-3177",
"fax_number": "936-249-6486"
}
],
"practiceLocations": [
{
"address_1": "1103 Water St",
"address_purpose": "LOCATION",
"city": "Navasota",
"state": "TX",
"postal_code": "778683174",
"country_code": "US",
"telephone_number": "936-825-2237",
"fax_number": "936-249-6486",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SEASONS ASSISTED LIVING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-11",
"last_updated": "2021-10-11",
"certification_date": "2021-10-11",
"status": "A",
"authorized_official_last_name": "MEDLIN",
"authorized_official_first_name": "SHAWN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "936-274-3177"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "311500000X",
"taxonomy_group": "",
"desc": "Alzheimer Center (Dementia Center)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHSC FACILITY ID #",
"identifier": "110211",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHSC LICENSE #",
"identifier": "146856",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHSC LICENSE #",
"identifier": "307467",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHSC FACILITY ID#",
"identifier": "104330",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.