Tall Pines Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

104411 Issued in TX

Legal business name

TALL PINES ASSISTED LIVING

Practice address

1437 S FM 1988
Livingston, TX 77351-4456

Phone

(936) 967-3636

Fax

(936) 967-3635

NPI assigned

Aug 12, 2010

Last updated

Aug 12, 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. Bruce Lee Ott

Title

Manager/Owner

Phone

(936) 967-3636

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1184939209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 S FM 1988",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514456",
            "telephone_number": "936-967-3636",
            "fax_number": "936-967-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 S FM 1988",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514456",
            "telephone_number": "936-967-3636",
            "fax_number": "936-967-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALL PINES ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "936-967-3636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "104411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Ray Sullivan, NP
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• Srinivas Sunkavally, M.D.
• Kayleigh Campbell Supak, LPC ASSOCIATE
• Sustaining Grace Counseling, PLLC
• Tall Pines Assisted Living
• Elaina Tapscott, PTA
• Dennis Wayne Teal, D.C.
• Mark Templet, RPH
• Texan EMS LLC (Texan EMS)

• Assisted Living Facility in Livingston, TX
• Providers in Livingston, TX by specialty
• Assisted Living Facility in Texas

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