NPIMap

Organization Active NPI

Educare Community Living Corporation - Gulf Coast

  • Intellectual Disabilities Intermediate Care Facility
  • Missouri City, TX
National Provider Identifier
1851716401
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
EDUCARE COMMUNITY LIVING CORPORATION - GULF COAST
Practice address
3419 Boca Raton Dr
Missouri City, TX 77459-4408
Phone
(502) 394-2100
NPI assigned
Feb 19, 2014
Last updated
Jul 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
Chief Regulatory Officer Sr Asst GC
Phone
(952) 836-2234

Specialties & licenses 1

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

Addresses

Primary practice location

3419 Boca Raton Dr
Missouri City, TX 77459-4408

Mailing address

6600 France Ave S Ste 350
Edina, MN 55435-1810
Phone (800) 388-5150

Other names 1

  • Fellows Block GH Other name

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 1851716401. Details of each certification follow.

  • CCN 45G423 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G423

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
EDUCARE COMMUNITY LIVING CORPORATION - GULF COAST
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 15, 1990
Last certification
Mar 21, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
3419 Boca Raton Drive
Missouri City, TX 77459

National Provider Directory

National Provider Directory
Tax ID family
Educare Community Living Corporation - Gulf Coast12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1851716401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 350",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "800-388-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 BOCA RATON DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594408",
            "telephone_number": "502-394-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCARE COMMUNITY LIVING CORPORATION - GULF COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER SR ASST GC",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fellows Block GH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.