Active NPI
Texas Ahcs 1, LP
- Skilled Nursing Facility
- Wells, TX
National Provider Identifier
1417029307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 114912
- Legal business name
- TEXAS AHCS 1, LP
- Practice address
- 46 May Street
Wells, TX 75976 - Phone
- (936) 867-4707
- Fax
- (936) 867-4709
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alan D Peterson, LNFA
- Title
- President
- Phone
- (817) 919-7435
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 114912 | TX | Primary |
Addresses
Primary practice location
46 May Street
Wells, TX 75976
Mailing address
46 May Street
Wells, TX 75976
Phone (936) 867-4707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5619 | Medicaid | TX |
Other names 1
- Hillside Plaza
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1417029307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 MAY STREET",
"city": "WELLS",
"state": "TX",
"postal_code": "75976",
"telephone_number": "936-867-4707",
"fax_number": "936-867-4709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 MAY STREET",
"city": "WELLS",
"state": "TX",
"postal_code": "75976",
"telephone_number": "936-867-4707",
"fax_number": "936-867-4709"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEXAS AHCS 1, LP",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PETERSON",
"authorized_official_first_name": "ALAN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "817-919-7435",
"authorized_official_credential": "LNFA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "114912",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5619",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hillside Plaza",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wells, TX
Sources for this page
- 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.