Bluebonnet Residential Center - General Partnership

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

115074 Issued in TX

Legal business name

BLUEBONNET RESIDENTIAL CENTER - GENERAL PARTNERSHIP

Practice address

524 N Pearson St
Godley, TX 76044-3702

Phone

(817) 389-3442

Fax

(817) 389-2354

NPI assigned

Apr 2, 2007

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

Mr. Stephen Joel Zager

Title

Financial Administrator

Phone

(817) 389-3442

Specialties & licenses 1

Addresses

Other names 1

• BLUEBONNET RESIDENTIAL CENTER Other name

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366563157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 N PEARSON ST",
            "city": "GODLEY",
            "state": "TX",
            "postal_code": "760443702",
            "telephone_number": "817-389-3442",
            "fax_number": "817-389-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 N PEARSON ST",
            "city": "GODLEY",
            "state": "TX",
            "postal_code": "760443702",
            "telephone_number": "817-389-3442",
            "fax_number": "817-389-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET RESIDENTIAL CENTER - GENERAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZAGER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "FINANCIAL ADMINISTRATOR",
        "authorized_official_telephone_number": "817-389-3442",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "115074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUEBONNET RESIDENTIAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Intellectual Disabilities Intermediate Care Facility in Godley, TX
• Providers in Godley, TX by specialty
• Intellectual Disabilities Intermediate Care 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.