Organization Active NPI

Crockett Senior Care LLC

Doing business as Community Care Center of Crockett

  • Skilled Nursing Facility
  • Crockett, TX
National Provider Identifier
1477877603
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CROCKETT SENIOR CARE LLC
Doing business as
Community Care Center of Crockett
Practice address
1150 E Loop 304
Crockett, TX 75835-1810
Phone
(936) 544-2051
NPI assigned
Mar 17, 2010
Last updated
Mar 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Mr. Joseph A Neal
Title
Member
Phone
(254) 399-6788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X TX Primary

Addresses

Primary practice location

1150 E Loop 304
Crockett, TX 75835-1810

Mailing address

200 W Highway 6
Suite 509
Waco, TX 76712-7923
Phone (254) 399-6788

Other names 1

  • COMMUNITY CARE CENTER OF CROCKETT Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1477877603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W HIGHWAY 6",
            "address_2": "SUITE 509",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127923",
            "telephone_number": "254-399-6788",
            "fax_number": "254-399-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E LOOP 304",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351810",
            "telephone_number": "936-544-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "254-399-6788",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CARE CENTER OF CROCKETT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crockett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.