NPIMap

Organization Active NPI

Golden Triangle Living Centers Inc

Doing business as Cheryl Living Center

  • Intellectual Disabilities Intermediate Care Facility
  • Beaumont, TX
National Provider Identifier
1790899615
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
116617 Issued in TX
Legal business name
GOLDEN TRIANGLE LIVING CENTERS INC
Doing business as
Cheryl Living Center
Practice address
3895 Cheryl St
Beaumont, TX 77706
Phone
(409) 892-7260
Fax
(409) 832-8044
NPI assigned
Aug 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jerrine B Harrell
Title
President
Phone
(318) 445-6470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 116617 TX Primary

Addresses

Primary practice location

3895 Cheryl St
Beaumont, TX 77706

Mailing address

2750 South 4TH St
Beaumont, TX 77701-7912
Phone (409) 832-4112

Other identifiers 1

IdentifierTypeStateIssuer
45G395MedicaidTX

Other names 1

  • Cheryl Living Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790899615. Details of each certification follow.

  • CCN 45G395 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G395

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHERYL LIVING CENTER
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 11, 1990
Last certification
Dec 4, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
3895 Cheryl Drive
Beaumont, TX 77706

National Provider Directory

National Provider Directory
Tax ID family
Golden Triangle Living Centers Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790899615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 SOUTH 4TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777017912",
            "telephone_number": "409-832-4112",
            "fax_number": "409-832-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 CHERYL ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-892-7260",
            "fax_number": "409-832-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN TRIANGLE LIVING CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "JERRINE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-445-6470",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "116617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45G395",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cheryl Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.