Pci Adult Daycare, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

138023 Issued in TX

Legal business name

PCI ADULT DAYCARE, LLC

Doing business as

The Rose Cottage of Texas

Practice address

6050 Harris Pkwy
Fort Worth, TX 76132-4102

Phone

(817) 921-9500

Fax

(817) 921-9576

NPI assigned

Jun 19, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Howard Don Petersen, CPA

Title

Cfo

Phone

(817) 637-9100

Specialties & licenses 1

Addresses

Other names 1

• The Rose Cottage of Texas Doing business as

Locations

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1730593476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324102",
            "telephone_number": "817-921-9500",
            "fax_number": "817-921-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324102",
            "telephone_number": "817-921-9500",
            "fax_number": "817-921-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCI ADULT DAYCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "817-637-9100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "TX",
            "license": "138023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Rose Cottage of Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyjvanna Payne, LPC
• Jasmine Payro, CST
• Hannah Kaye Payton, PA-C
• PB Monitoring LLC
• PB&K, LLC
• PCPT, PLLC
• Peacemakers
• David Owen Peach, AU.D.
• Audrey Nicole Peacock, DDS
• Robert Morgan Peacock, LCSW

• Adult Day Care Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.