PHPM Mission Care Centers - New Covenant LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

113790 Issued in TX

Legal business name

PHPM MISSION CARE CENTERS - NEW COVENANT LP

Doing business as

Garden Villa Nursing Home

Practice address

106 Del Norte Dr
El Campo, TX 77437-2504

Phone

(979) 543-6762

Fax

(979) 543-9626

NPI assigned

Nov 16, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Jamie Latture Collier

Title

Director of Reimbursement

Phone

(972) 731-3800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Garden Villa Nursing Home Doing business as

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1164404075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 W PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934823",
            "telephone_number": "972-931-3800",
            "fax_number": "972-767-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 DEL NORTE DR",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774372504",
            "telephone_number": "979-543-6762",
            "fax_number": "979-543-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHPM MISSION CARE CENTERS - NEW COVENANT LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LATTURE",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "972-731-3800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "113790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013031",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden Villa Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in El Campo, TX
• Providers in El Campo, 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 Nov 13, 2014; 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.