Livingston Health Care Center LTD. Co.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

114558 Issued in TX

Legal business name

LIVINGSTON HEALTH CARE CENTER LTD. CO.

Doing business as

The Bradford at Brookside

Practice address

301 West Park Drive
Livingston, TX 77351-8151

Phone

(936) 327-4341

Fax

(936) 327-6277

NPI assigned

Sep 22, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Robin Underhill

Title

Chief Executive

Phone

(214) 954-4114

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• The Bradford at Brookside Doing business as

Locations

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229644800000",
    "number": "1821084138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 GOLDEN BEAR DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "750062377",
            "telephone_number": "214-954-4114",
            "fax_number": "214-871-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 WEST PARK DRIVE",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773518151",
            "telephone_number": "936-327-4341",
            "fax_number": "936-327-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTON HEALTH CARE CENTER LTD. CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2008-12-19",
        "status": "A",
        "authorized_official_last_name": "UNDERHILL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE",
        "authorized_official_telephone_number": "214-954-4114",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "114558",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022634201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155314101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HH068S",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000465804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Bradford at Brookside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Livingston, TX
• Providers in Livingston, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.