Senior Living Properties LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

123157 Issued in TX

Legal business name

SENIOR LIVING PROPERTIES LLC

Doing business as

Van Healthcare Center

Practice address

169 S Oak St
Van, TX 75790-3529

Phone

(903) 963-8641

Fax

(903) 963-5413

NPI assigned

May 20, 2006

Last updated

Mar 18, 2010By 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

Larry Martin

Title

Cfo

Phone

(817) 410-7300

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Van Healthcare Center Doing business as

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1093769325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1389",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760991389",
            "telephone_number": "817-410-7300",
            "fax_number": "817-410-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 S OAK ST",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757903529",
            "telephone_number": "903-963-8641",
            "fax_number": "903-963-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIVING PROPERTIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "817-410-7300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "123157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID NO.",
            "identifier": "004671",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000467107",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Nicole Newton, APRN, FNP-C
• Pat Oxford, RPH
• Leslie Michelle Pack, RN
• Kimberly Kay Raglin, LVN
• Callie Lynn Roberts
• Senior Living Properties LLC (Country Inn Healthcare Center)
• Leah Skow, M.S., CCC-SLP
• South Limestone Hospital District (Van Healthcare)
• Van Family Medical
• Van Health and Wellness, PLLC

• Skilled Nursing Facility in Van, TX
• Providers in Van, 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 Mar 18, 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.