NPIMap

Organization Active NPI

Lutheran Social Services of the South, Inc.

  • Adult Day Care Clinic/Center
  • El Paso, TX
National Provider Identifier
1164579173
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
003245 Issued in TX
Legal business name
LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.
Practice address
9640 Montwood Dr
El Paso, TX 79925-6032
Phone
(915) 598-5403
Fax
(915) 592-7399
NPI assigned
Jan 4, 2007
Organization subpart
Yes
Parent organization
LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Authorized official

Name
Mr. John Berkely
Title
Vice President Senior Services
Phone
(512) 459-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 003245 TX Primary

Addresses

Primary practice location

9640 Montwood Dr
El Paso, TX 79925-6032

Mailing address

PO Box 140767
Austin, TX 78714-0767
Phone (512) 459-1000

Other identifiers 1

IdentifierTypeStateIssuer
000324500MedicaidTX

Other names 1

  • Eastside Adult Day Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Social Services of the South Inc11 organizations share this tax ID, including this one
Part of
Lutheran Social Services of the South Inc

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9640 Montwood Dr
El Paso, TX 79925
Phone (915) 598-5403

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1164579173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140767",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787140767",
            "telephone_number": "512-459-1000",
            "fax_number": "512-452-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 MONTWOOD DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799256032",
            "telephone_number": "915-598-5403",
            "fax_number": "915-592-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.",
        "enumeration_date": "2007-01-04",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "BERKELY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT SENIOR SERVICES",
        "authorized_official_telephone_number": "512-459-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "TX",
            "license": "003245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000324500",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Adult Day Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.