At Ease Veteran Community Resource

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AT EASE VETERAN COMMUNITY RESOURCE

Practice address

819 Beech St
Texarkana, AR 71854-5316

Phone

(817) 807-6333

NPI assigned

Jan 26, 2021

Last updated

Jan 26, 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

Mr. Jervis Williams

Title

Cfo

Phone

(817) 807-6333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1942890652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 BEECH ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545316",
            "telephone_number": "817-807-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 BEECH ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545316",
            "telephone_number": "817-807-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT EASE VETERAN COMMUNITY RESOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JERVIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "817-807-6333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.