Community SCC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COMMUNITY SCC LLC

Doing business as

Abri at Stephenville

Practice address

2601 Northwest Loop
Stephenville, TX 76401-1712

Phone

(254) 968-4649

Fax

(254) 968-5535

NPI assigned

Oct 26, 2010

Last updated

Mar 16, 2022By 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

Michael Templeton

Title

Chief Operations Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Abri at Stephenville Doing business as

Locations

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1871893792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547685",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 NORTHWEST LOOP",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764011712",
            "telephone_number": "254-968-4649",
            "fax_number": "254-968-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "TEMPLETON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001018974",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abri at Stephenville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Wayne Max Cooper, PTA

• Skilled Nursing Facility in Stephenville, TX
• Providers in Stephenville, 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 Mar 16, 2022; 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.