Mineola Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5037 Issued in TX

Legal business name

MINEOLA HEALTHCARE LLC

Doing business as

Community Care Center Of Mineola

Practice address

716 Mimosa Dr
Mineola, TX 75773-2612

Phone

(903) 569-5366

NPI assigned

Jan 28, 2009

Last updated

Dec 1, 2016By 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

Mr. Mendy Shapiro

Title

Manager

Phone

(903) 569-5366

Specialties & licenses 1

Addresses

Other names 1

• Community Care Center Of Mineola Doing business as

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1942448931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MONMOUTH AVE",
            "address_2": "SUITE 130",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 MIMOSA DR",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757732612",
            "telephone_number": "903-569-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINEOLA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "MENDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "903-569-5366",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "5037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Center Of Mineola",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Metx, LLC
• Conner Miellmier
• Traci Layne Miller, RD
• Mineola Counseling Services
• Mineola Dental PLLC
• Mineola Independent School District
• Mineola Medical Center PLLC
• Mineola Nursing and Rehab Center (Mineola Healthcare Residence)
• Mineola Senior Living, LLC (Autumn Wind Mineola)
• Anna Rachel Mitchell

• Skilled Nursing Facility in Mineola, TX
• Providers in Mineola, 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 Dec 1, 2016; 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.