Rebecca Ann Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

110076 Issued in TX

Legal business name

REBECCA ANN INC

Doing business as

Village on the Creek Health Care Center

Practice address

914 N Brazosport Blvd
Clute, TX 77531-3720

Phone

(979) 265-4794

Fax

(979) 265-4898

NPI assigned

Mar 22, 2006

Last updated

Oct 26, 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

Mr. Paul Heinig

Title

President

Phone

(979) 297-0425

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Village on the Creek Health Care Center Doing business as

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1154380699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N BRAZOSPORT BLVD",
            "city": "CLUTE",
            "state": "TX",
            "postal_code": "775313720",
            "telephone_number": "979-265-4794",
            "fax_number": "979-265-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N BRAZOSPORT BLVD",
            "city": "CLUTE",
            "state": "TX",
            "postal_code": "775313720",
            "telephone_number": "979-265-4794",
            "fax_number": "979-265-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA ANN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "HEINIG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-297-0425",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "110076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000466306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village on the Creek Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Clute, TX
• Providers in Clute, 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 26, 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.