Kilgore Al Management LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

103201 Issued in TX

Legal business name

KILGORE AL MANAGEMENT LLC

Doing business as

Arabella of Kilgore

Practice address

2103 Chandler St
Kilgore, TX 75662-3741

Phone

(903) 984-8839

NPI assigned

Feb 1, 2016

Last updated

Feb 1, 2016By 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

Lawrence Wayne Powell Jr.

Title

President

Phone

(817) 386-8888

Specialties & licenses 1

Addresses

Other names 1

• Arabella of Kilgore Doing business as

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1346608700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3973 W VICKERY BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076492",
            "telephone_number": "817-386-8888",
            "fax_number": "817-386-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 CHANDLER ST",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623741",
            "telephone_number": "903-984-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILGORE AL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-386-8888",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "103201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arabella of Kilgore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Charles Johnson, PHARM. D.
• Jack Johnston, DDS
• Marithy Jones
• Alaina Jordan, LCDC
• Kal 2016, LLC (Arabella of Kilgore)
• Kilgore Chiropractic Clinic Inc
• Kilgore Healthcare LLC
• Kilgore I Enterprises, LLC (Kilgore Health & Rehabilitation)
• Kilgore Independent School District
• Kilgore Integrated Health PLLC

• Assisted Living Facility in Kilgore, TX
• Providers in Kilgore, 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 1, 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.