Balch Springs Nursing Home, L.P.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

114513 Issued in TX

Legal business name

BALCH SPRINGS NURSING HOME, L.P.

Doing business as

Balch Springs Nursing Home

Practice address

4200 Shepherd LN
Balch Springs, TX 75180-3423

Phone

(972) 286-0335

Fax

(972) 286-7514

NPI assigned

Oct 11, 2005

Last updated

Oct 25, 2007By 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. Peter J Licari

Title

President of General Partner

Phone

(215) 441-7700

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Balch Springs Nursing Home Doing business as

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1386632750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DRYDEN ROAD",
            "address_2": "SUITE 2000",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "19025",
            "telephone_number": "215-441-7700",
            "fax_number": "215-441-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SHEPHERD LN",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751803423",
            "telephone_number": "972-286-0335",
            "fax_number": "972-286-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALCH SPRINGS NURSING HOME, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "LICARI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT OF GENERAL PARTNER",
        "authorized_official_telephone_number": "215-441-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "114513",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "TX",
            "license": "114513",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "114513",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balch Springs Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Balch Springs, TX
• Providers in Balch Springs, 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 Oct 25, 2007; 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.