Century Mission Oaks Geac LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

112541 Issued in TX

Legal business name

CENTURY MISSION OAKS GEAC LLC

Practice address

3030 Roosevelt Ave
San Antonio, TX 78214-2337

Phone

(210) 924-8151

Fax

(210) 924-2208

NPI assigned

Jul 13, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Myrna Robinson

Title

Facility Administrator

Phone

(210) 924-8151

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1154329043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 ROOSEVELT AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782142337",
            "telephone_number": "210-924-8151",
            "fax_number": "210-924-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 ROOSEVELT AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782142337",
            "telephone_number": "210-924-8151",
            "fax_number": "210-924-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURY MISSION OAKS GEAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "210-924-8151",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "112541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005051",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.