New Haven Assisted Living & Memory Care

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

140434 Issued in TX

Legal business name

NEW HAVEN ASSISTED LIVING & MEMORY CARE

Practice address

107 Creekside TRL
Kyle, TX 78640-6261

Phone

(512) 400-0683

Fax

(512) 400-0684

NPI assigned

Jan 9, 2015

Organization subpart

No

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

Authorized official

Name

Richard Nicholls

Title

Regional President

Phone

(847) 975-1609

Specialties & licenses 2

Addresses

Other names 1

• 65 Alive, LLC Other name

Locations

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1699164954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CREEKSIDE TRL",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406261",
            "telephone_number": "512-400-0683",
            "fax_number": "512-400-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CREEKSIDE TRL",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406261",
            "telephone_number": "512-400-0683",
            "fax_number": "512-400-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN ASSISTED LIVING & MEMORY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "NICHOLLS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "REGIONAL PRESIDENT",
        "authorized_official_telephone_number": "847-975-1609"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "140434",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "TX",
            "license": "140429/103276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "65 Alive, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Adrienne Fayette Nash, APRN, ACNPC-AG
• Saray Navarrete, PA-C
• Amanda Marie Navarro
• David Cox Needham, M.D.
• Chloe S Nelson
• Danielle Newcomb, PTA
• Joycelyn NG
• Amy Nguyen, D.M.D.
• Daniel V Nguyen, MD
• Hoang Dinh Nguyen, RPH

• Assisted Living Facility in Kyle, TX
• Providers in Kyle, 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 Jan 9, 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.