21St Century Living Centers

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

000762301 Issued in TX

Legal business name

21ST CENTURY LIVING CENTERS

Practice address

2410 Taylor St
Southlake, TX 76092-3316

Phone

(817) 424-3338

NPI assigned

Aug 9, 2007

Organization subpart

No

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

Authorized official

Name

Michelle Deanne Neal

Title

Admin/Assistant QMRP

Phone

(817) 481-5368

Specialties & licenses 1

Addresses

Other names 1

• BROOKWOOD III Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45H183

Legal name

BROOKWOOD I I I

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Aug 11, 1994

Last certification

Dec 5, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

2410 Taylor St
Southlake, TX 76092

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1760673164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 LONESOME DOVE RD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923223",
            "telephone_number": "817-481-5368",
            "fax_number": "817-251-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 TAYLOR ST",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923316",
            "telephone_number": "817-424-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY LIVING CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "DEANNE",
        "authorized_official_title_or_position": "ADMIN/ASSISTANT QMRP",
        "authorized_official_telephone_number": "817-481-5368"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "000762301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKWOOD III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 100 Chiro Prince PLLC
• 180 Wellness, LLP
• 2020 Eyedr
• 24-7 Air Evac, Inc.
• 2W Senior Care Limited Liability Company
• A Mile of Comfort LLC
• A1B Healthcare
• Aaron C Eubanks MD PA

• Intellectual Disabilities Intermediate Care Facility in Southlake, TX
• Providers in Southlake, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.