Performance Care Centers LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PERFORMANCE CARE CENTERS LLC

Doing business as

Mira Vista Court

Practice address

7021 Bryant Irvin Road
Fort Worth, TX 76132

Phone

(817) 535-3447

NPI assigned

Aug 8, 2013

Last updated

Feb 7, 2014By 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

Lezlie Michael

Title

President

Phone

(817) 361-1400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mira Vista Court Doing business as

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1245662675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7021 BRYANT IRVIN ROAD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323834",
            "telephone_number": "817-361-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 BRYANT IRVIN ROAD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-535-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE CARE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-08",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "LEZLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-361-1400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025484",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mira Vista Court",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, 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 7, 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.