Nimrod Nation Enterprise LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

NIMROD NATION ENTERPRISE LLC

Doing business as

Hero's Haven

Practice address

1700 W Polo Rd Ste 128
Grand Prairie, TX 75052-1821

Phone

(318) 230-8414

Fax

(318) 626-7179

NPI assigned

Aug 26, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Rasby G Mason III

Title

Owner

Phone

(318) 230-8410

Specialties & licenses 13

Addresses

Other names 1

• Hero's Haven Doing business as

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1275252652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W POLO RD STE 128",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521821",
            "fax_number": "318-626-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W POLO RD STE 128",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521821",
            "telephone_number": "318-230-8414",
            "fax_number": "318-626-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIMROD NATION ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "RASBY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-230-8410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lashonda.mason@ymail.com",
            "affiliation": "N",
            "address_1": "1700 W Polo Rd Ste 128",
            "city": "Grand Prairie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750521821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lashonda.mason@ymail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 W Polo Rd Ste 128",
            "city": "Grand Prairie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750521821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hero's Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lydie Akwese Ngwepekem
• Reginah Mbula Ngwili
• Elvis Ngyia, PHD, NP-C, PMHNP-C
• Ejang Ngyiah, PMHNP-BC
• Celina J Nigo, B.S., SLP-ASSISTANT
• Linda Ninh, MS, RD, LD
• Roland Njumentoko
• Mispa Ewube Nkongho, NP
• Nnaemeka Morah (Moradicom Imaging)
• Norberto J C Montani & Associates

• Adult Day Care Clinic/Center in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.