Plum Tree

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

0010070064 Issued in TX

Legal business name

PLUM TREE

Practice address

925 Kennedale Pkwy
Kennedale, TX 76060

Phone

(682) 587-8523

Fax

(682) 587-8526

NPI assigned

Oct 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim Hampton

Title

President

Phone

(682) 587-8523

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790879302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 172991",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760032991",
            "telephone_number": "682-587-8523",
            "fax_number": "682-587-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 KENNEDALE PKWY",
            "city": "KENNEDALE",
            "state": "TX",
            "postal_code": "76060",
            "telephone_number": "682-587-8523",
            "fax_number": "682-587-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLUM TREE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "682-587-8523"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": "0010070064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Suzanne Parsons, MS
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• Iris Pineda, SA-C
• Jose Enrique Portales, ATC, LAT
• Greg Powers, LCSW
• Rainey Nicole Prater, OTA
• Macy Pride, RDN, LD
• Ray's Pharmacy, Inc. (Ray's Pharmacy #2)

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kennedale, TX
• Providers in Kennedale, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.