Astrid Village Assisted Centre

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ASTRID VILLAGE ASSISTED CENTRE

Practice address

2860 Clear Creek Dr
Rockwall, TX 75032-9247

Phone

(214) 766-1174

NPI assigned

Feb 26, 2016

Organization subpart

No

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

Authorized official

Name

Ngozi Stephanie Chukwukelu, RN

Title

Program Director

Phone

(214) 766-1174

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1245690676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 PLAZA BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752416439",
            "telephone_number": "214-766-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 CLEAR CREEK DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750329247",
            "telephone_number": "214-766-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTRID VILLAGE ASSISTED CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "CHUKWUKELU",
        "authorized_official_first_name": "NGOZI",
        "authorized_official_middle_name": "STEPHANIE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "214-766-1174",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.