Revered Texan Hearth & Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

130441 Issued in TX

Legal business name

REVERED TEXAN HEARTH & HOME, LLC

Practice address

1005 Sycamore St
Lake Jackson, TX 77566-6137

Phone

(979) 266-9982

Fax

(979) 266-9982

NPI assigned

Apr 20, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Karen Denise Ashcraft, RN

Title

Owner/Manager

Phone

(979) 266-9982

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1487945705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 SYCAMORE ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666137",
            "telephone_number": "979-266-9982",
            "fax_number": "979-266-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 SYCAMORE ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666137",
            "telephone_number": "979-266-9982",
            "fax_number": "979-266-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVERED TEXAN HEARTH & HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "ASHCRAFT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "979-266-9982",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "130441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.