Southwest Fort Worth Memory Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

104331 Issued in TX

Legal business name

SOUTHWEST FORT WORTH MEMORY CARE, LLC

Practice address

7100 Dutch Branch Rd
Ft Worth, TX 76132-6111

Phone

(817) 769-3800

Fax

(817) 769-3801

NPI assigned

Feb 20, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Chad Anderson

Title

President

Phone

(214) 845-4500

Specialties & licenses 1

Addresses

Other names 1

• Autumn Leaves of Cityview Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1316210552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E JOHN CARPENTER FWY",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623931",
            "telephone_number": "214-845-4500",
            "fax_number": "214-845-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 DUTCH BRANCH RD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761326111",
            "telephone_number": "817-769-3800",
            "fax_number": "817-769-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FORT WORTH MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-20",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-845-4500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "104331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Leaves of Cityview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Alberta Southward
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• Southwest Fort Worth Anesthesia Consultants, PA
• Southwest Fort Worth Anesthesiology Consultants, PA
• Southwest Home Care, LLC
• Southwest Internal Medicine PA
• Southwest LTC - Fort Worth Alf, LLC
• Southwest LTC - Fort Worth Alf, LLC
• Southwest Physical Medicine, PLLC

• Assisted Living Facility in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.