Active NPI
Vintage SCC LLC
- Assisted Living Facility
- Denton, TX
National Provider Identifier
1679718407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- VINTAGE SCC LLC
- Practice address
- 205 N Bonnie Brae St
Denton, TX 76201-3766 - Phone
- (940) 373-4766
- Fax
- (940) 320-6645
- NPI assigned
- Dec 8, 2008
- 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
- Jason Price
- Title
- Senior Vice President
- Phone
- (949) 436-4343
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | TX | Primary |
Addresses
Primary practice location
205 N Bonnie Brae St
Denton, TX 76201-3766
Mailing address
205 N Bonnie Brae St
Denton, TX 76201-3766
Phone (940) 373-4766
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001017205 | Medicaid | TX | |
| 000544 | Other | TX | FACILITY ID |
Other names 1
- Vintage Health Care Center
National Provider Directory
National Provider Directory- Tax ID family
- Senior Care Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Denton, TX
- NPI 1124022470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228694400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1599177600000",
"number": "1679718407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N BONNIE BRAE ST",
"city": "DENTON",
"state": "TX",
"postal_code": "762013766",
"telephone_number": "940-373-4766",
"fax_number": "940-320-6645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N BONNIE BRAE ST",
"city": "DENTON",
"state": "TX",
"postal_code": "762013766",
"telephone_number": "940-373-4766",
"fax_number": "940-320-6645"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VINTAGE SCC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-08",
"last_updated": "2020-09-04",
"certification_date": "2020-09-04",
"status": "A",
"authorized_official_last_name": "PRICE",
"authorized_official_first_name": "JASON",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "949-436-4343"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001017205",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FACILITY ID",
"identifier": "000544",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Vintage Health Care Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Vintage Health Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.