21Stcentury Homecare Services

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

21STCENTURY HOMECARE SERVICES

Practice address

6710 Lindale Manor CT
Spring, TX 77379-8931

Phone

(832) 656-4391

NPI assigned

Apr 14, 2014

Last updated

Apr 14, 2014By 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

Kenneth Ray Johnson Jr.

Title

Ceo

Phone

(832) 656-4391

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1861811218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 BENMAR DR",
            "address_2": "3053",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770603165",
            "telephone_number": "832-326-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 LINDALE MANOR CT",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773798931",
            "telephone_number": "832-656-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21STCENTURY HOMECARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-656-4391",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103T00000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Spring, TX
• Providers in Spring, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.