Pyramid Healthcare Corp

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

112891 Issued in TX

Legal business name

PYRAMID HEALTHCARE CORP

Doing business as

Itasca Nursing Home

Practice address

409 N Files St
Itasca, TX 76055-2336

Phone

(254) 687-2383

Fax

(254) 687-2565

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By 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

Mrs. Patricia Diane Ward, RN

Title

Ceo President

Phone

(254) 580-9424

Specialties & licenses 1

Addresses

Other names 1

• Itasca Nursing Home Doing business as

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295891208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2105",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766925105",
            "telephone_number": "254-580-9424",
            "fax_number": "254-580-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N FILES ST",
            "city": "ITASCA",
            "state": "TX",
            "postal_code": "760552336",
            "telephone_number": "254-687-2383",
            "fax_number": "254-687-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "254-580-9424",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "112891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Itasca Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Itasca Long Term Care, LLC (Homestead Nursing and Rehabilitation of Itasca)
• Cydnei Octavia Wells, LAT

• Skilled Nursing Facility in Itasca, TX
• Providers in Itasca, 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 Aug 22, 2020; 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.