PM Management - Golden Triangle NC I LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

131483 Issued in TX

Legal business name

PM MANAGEMENT - GOLDEN TRIANGLE NC I LLC

Doing business as

Summer Place Nursing & Rehabilitation

Practice address

2485 S Major Dr
Beaumont, TX 77707-5019

Phone

(409) 861-4611

Fax

(409) 861-4632

NPI assigned

Dec 8, 2010

Organization subpart

No

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

Authorized official

Name

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Summer Place Nursing & Rehabilitation Doing business as

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1356644694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 S MAJOR DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777075019",
            "telephone_number": "409-861-4611",
            "fax_number": "409-861-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT - GOLDEN TRIANGLE NC I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "131483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019216",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAC. ID",
            "identifier": "103768",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summer Place Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summer Place Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Beaumont, TX
• Providers in Beaumont, 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 Mar 4, 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.