Simple Residential Care LTD. Co

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SIMPLE RESIDENTIAL CARE LTD. CO

Practice address

109 Springridge LN
Euless, TX 76039-8031

Phone

(817) 808-5630

Fax

(877) 335-9334

NPI assigned

Jun 30, 2015

Organization subpart

No

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

Authorized official

Name

Shahidaa Abdullah

Title

Owner

Phone

(817) 808-5630

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1609259308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SPRINGRIDGE LN",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760398031",
            "telephone_number": "817-808-5630",
            "fax_number": "877-335-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SPRINGRIDGE LN",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760398031",
            "telephone_number": "817-808-5630",
            "fax_number": "877-335-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLE RESIDENTIAL CARE LTD. CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "ABDULLAH",
        "authorized_official_first_name": "SHAHIDAA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-808-5630"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Euless, TX
• Providers in Euless, TX by specialty
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.