My Beach House LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

113832 Issued in TX

Legal business name

MY BEACH HOUSE LLC

Practice address

508 S Donald St
Seymour, TX 76380-2812

Phone

(940) 889-4911

Fax

(940) 889-4912

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Glenna Jo Decker, LVN

Title

Manager

Phone

(940) 889-4911

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1730370883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S DONALD ST",
            "city": "SEYMOUR",
            "state": "TX",
            "postal_code": "763802812",
            "telephone_number": "940-889-4911",
            "fax_number": "940-889-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S DONALD ST",
            "city": "SEYMOUR",
            "state": "TX",
            "postal_code": "763802812",
            "telephone_number": "940-889-4911",
            "fax_number": "940-889-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY BEACH HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "GLENNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "940-889-4911",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "113832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Just Like Home Seymour, LLC
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• Selah Mauldin, DO
• Deangelia Hoyt Morrow, ABOC
• Christie Dianne Munoz, M.D.
• Michael J Newman, DDS
• Kimberly D Nix, CRNA
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• Assisted Living Facility in Seymour, TX
• Providers in Seymour, 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 Aug 5, 2007; 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.