Diversicare Treemont LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

120029 Issued in TX

Legal business name

DIVERSICARE TREEMONT LLC

Doing business as

Treemont Healthcare and Rehabilitation Center

Practice address

5550 Harvest Hill Rd
Suite 500
Dallas, TX 75230-1624

Phone

(972) 661-1862

Fax

(972) 980-6731

NPI assigned

Jul 13, 2007

Organization subpart

Yes

Parent organization

ADVOCAT INC.As reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Treemont Healthcare and Rehabilitation Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Diversicare Leasing LP

  dba Diversicare of Martin

  • Skilled Nursing Facility
  • Martin, TN
  • NPI 1538157664

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1235338732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 HARVEST HILL RD",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301624",
            "telephone_number": "972-661-1862",
            "fax_number": "972-980-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 HARVEST HILL RD",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301624",
            "telephone_number": "972-661-1862",
            "fax_number": "972-980-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE TREEMONT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCAT INC.",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "120029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SNF",
            "identifier": "45-5823",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treemont Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Gerald Ditzler, MD
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• Abhay Ashok Divekar, MD, MBBS
• Diverge and Bloom Counseling, PLLC
• Diversicare Doctors LLC (Diversicare of Lake Highlands)
• Divine Behavioral Health Clinic PLLC
• Divine Care Hospice LLC
• Divine Healing Space, PLLC
• Divine Healing Supplies
• Divine Medical Equipment, Inc

• Skilled Nursing Facility in Dallas, TX
• Providers in Dallas, 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 Feb 18, 2015; 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.