Mount Vernon Healthcare Residence LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

004659 Issued in TX

Legal business name

MOUNT VERNON HEALTHCARE RESIDENCE LLC

Doing business as

Mission Manor Healthcare Residence

Practice address

501 Yates St
Mount Vernon, TX 75457-3233

Phone

(214) 396-3462

NPI assigned

Nov 28, 2014

Last updated

Jun 20, 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

Joe Neuman

Title

Chief Executive Officer

Phone

(214) 396-3462

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mission Manor Healthcare Residence Doing business as

Locations

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

{
    "created_epoch": "1417132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1346647898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CLIFTON AVE STE 12",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013342",
            "telephone_number": "214-396-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 YATES ST",
            "city": "MOUNT VERNON",
            "state": "TX",
            "postal_code": "754573233",
            "telephone_number": "214-396-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON HEALTHCARE RESIDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-28",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-396-3462"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "004659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026912",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Manor Healthcare Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medlife Pharmacy
• Michael a. Walker, D.O., P.a.
• MJ Management
• Mother Frances Hospital-Winnsboro (Family Care Center Mt Vernon)
• Mount Vernon Eye Care & Eyewear Gallery PLLC
• Mt Vernon Chiropractic Clinic PLLC (Mt Vernon Chiropractic Clininc)
• Mt Vernon Independent School Dist
• Mt Vernon Nursing Home Inc (Mission Manor Nursing Home)
• N.E.T. Opportunies, Inc.
• Irene Luisa Prather, MD

• Skilled Nursing Facility in Mount Vernon, TX
• Providers in Mount Vernon, 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 Jun 20, 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.