Thi of Texas at Mimosa, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THI OF TEXAS AT MIMOSA, LLC

Practice address

459 Keller Pkwy
Keller, TX 76248-2302

Phone

(817) 431-2518

Fax

(817) 379-0369

NPI assigned

Oct 7, 2006

Organization subpart

No

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

Authorized official

Name

David Kreuzer

Title

President

Phone

(817) 431-2518

Specialties & licenses 1

Addresses

Other names 1

• Mimosa Manor Doing business as

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1942397138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482302",
            "telephone_number": "817-431-2518",
            "fax_number": "817-379-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF TEXAS AT MIMOSA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "KREUZER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-431-2518"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mimosa Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.