Rockwall Memory Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

104597 Issued in TX

Legal business name

ROCKWALL MEMORY CARE, LLC

Doing business as

Autumn Leaves of Rockwall

Practice address

225 E Ralph Hall Parkway
Rockwall, TX 75032

Phone

(469) 402-1883

Fax

(469) 402-1888

NPI assigned

Mar 7, 2012

Last updated

Mar 7, 2012By 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. Chad Anderson

Title

President

Phone

(214) 845-4500

Specialties & licenses 1

Addresses

Other names 1

• Autumn Leaves of Rockwall Doing business as

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1699049718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E JOHN CARPENTER FWY",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623931",
            "telephone_number": "214-845-4500",
            "fax_number": "214-845-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E RALPH HALL PARKWAY",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "75032",
            "telephone_number": "469-402-1883",
            "fax_number": "469-402-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWALL MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-845-4500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "104597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Leaves of Rockwall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Rockwall, TX
• Providers in Rockwall, 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 Mar 7, 2012; 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.