Arboretum Health Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

115207 Issued in TX

Legal business name

ARBORETUM HEALTH CARE, INC.

Doing business as

Renaissance Villa

Practice address

700 Dyer St
Rockdale, TX 76567-2208

Phone

(512) 446-2548

Fax

(512) 446-4277

NPI assigned

Oct 17, 2006

Last updated

Jul 28, 2015By 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. Carl Fellbaurm

Title

President

Phone

(210) 828-5686

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Renaissance Villa Doing business as

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1639259179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W NOTTINGHAM DR",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78209",
            "telephone_number": "210-828-5686",
            "fax_number": "210-824-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 DYER ST",
            "city": "ROCKDALE",
            "state": "TX",
            "postal_code": "765672208",
            "telephone_number": "512-446-2548",
            "fax_number": "512-446-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBORETUM HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "FELLBAURM",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-828-5686",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "115207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000418403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Nicole Abrams, RN,MSN,FNP-C
• Advanced Living Technologies Inc (Manor Oaks Nursing Center)
• Johna Alford, CHN
• Anchor to Serenity LLC
• Thomas S Anderson, BSC,RVS,RCS
• Bio-Medical Applications of Texas, Inc. (Rockdale Kidney Center)
• Blackhawk Physician Group
• Kyle Bow, PTA
• Earl A Bowen, RPH
• Brazos Valley Community Action Agency, Inc. (HealthPoint)

• Skilled Nursing Facility in Rockdale, TX
• Providers in Rockdale, 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 Jul 28, 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.