Civitas Senior Healthcare, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CIVITAS SENIOR HEALTHCARE, LLC

Doing business as

Civitas Senior Living

Practice address

930 W 1St St Ste 400
Fort Worth, TX 76102-2743

Phone

(817) 386-8888

NPI assigned

Mar 31, 2021

Last updated

Mar 31, 2021By 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

Cooper Vittitow

Title

President

Phone

(817) 454-5561

Specialties & licenses 1

Addresses

Other names 1

• Civitas Senior Living Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1942888953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 W 1ST ST STE 400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761022743",
            "telephone_number": "817-386-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W 1ST ST STE 400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761022743",
            "telephone_number": "817-386-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVITAS SENIOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "VITTITOW",
        "authorized_official_first_name": "COOPER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-454-5561"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbailey@csrliving.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "930 W 1st St Ste 400",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761022743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Civitas Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.