The Village at Gleannloch Farms, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

126881 Issued in TX

Legal business name

THE VILLAGE AT GLEANNLOCH FARMS, INC

Practice address

9505 Northpointe Blvd
Spring, TX 77379-3799

Phone

(281) 430-4941

Fax

(281) 430-4907

NPI assigned

Jul 7, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Tab Allen Werner, LNFA

Title

Director of Health Services

Phone

(281) 430-4941

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Village at Gleannloch Farms Doing business as

Tax ID family

CCRC Opco - Gleannloch Farms LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• CCRC Opco - Gleannloch Farms, LLC

  • Skilled Nursing Facility
  • Spring, TX
  • NPI 1528439858
  NPD tax ID

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1710140173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9505 NORTHPOINTE BLVD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793799",
            "telephone_number": "281-430-4941",
            "fax_number": "281-430-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9505 NORTHPOINTE BLVD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793799",
            "telephone_number": "281-430-4941",
            "fax_number": "281-430-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VILLAGE AT GLEANNLOCH FARMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "TAB",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SERVICES",
        "authorized_official_telephone_number": "281-430-4941",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "127078",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "126881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017154",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Gleannloch Farms",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.