PM Management Corsicana NC II LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

131490 Issued in TX

Legal business name

PM MANAGEMENT CORSICANA NC II LLC

Doing business as

Heritage Oaks Retirement Village

Practice address

3002 W 2ND Ave
Corsicana, TX 75110-2492

Phone

(903) 872-1530

Fax

(903) 872-5949

NPI assigned

Dec 2, 2010

Organization subpart

No

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

Authorized official

Name

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Heritage Oaks Retirement Village Doing business as

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1891097432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 W 2ND AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102492",
            "telephone_number": "903-872-1530",
            "fax_number": "903-872-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT CORSICANA NC II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "132227",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "131490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "005357",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019214",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Oaks Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Oaks Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin B Pillans, DDS
• PM Management - Corsicana NC II LLC (Heritage Oaks Retirement Village)
• PM Management - Corsicana NC III LLC (Heritage Oaks West Retirement Village)
• PM Management - Corsicana NC LLC (Trisun Care Center - Corsicana)
• PM Management -Corsicana NC II, LLC (Heritage Oaks Retirement Village (ALF))
• Podiatric Medical Partners of Texas, PA (Family Foot & Ankle Centers)
• Tara Podjenski, LPC
• Maria Del Pilar Ponce, APRN
• Rosetta Porter, MCD, CCC-SLP
• Betty Prather

• Skilled Nursing Facility in Corsicana, TX
• Providers in Corsicana, 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 5, 2020; 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.