Fort Worth Senior Care, LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

FORT WORTH SENIOR CARE, LLC

Doing business as

Lakewood Village Personal Care Unit

Practice address

5100 Randol Mill Rd
Fort Worth, TX 76112-1553

Phone

(817) 548-3200

NPI assigned

Aug 19, 2024

Last updated

Sep 13, 2024By 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

Cynthia Matheny

Title

Authorized Signatory

Phone

(423) 883-7920

Specialties & licenses 2

Addresses

Other names 1

• Lakewood Village Personal Care Unit Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Christian Care Outpatient Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Worth Senior Care, LLC

  dba Christian Care Outpatient Therapy

  • Rehabilitation Clinic/Center
  • Fort Worth, TX
  • NPI 1043927247
  NPD tax ID

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1952133886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RANDOL MILL RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761121553",
            "telephone_number": "817-548-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 RANDOL MILL RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761121553",
            "telephone_number": "817-548-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH SENIOR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "MATHENY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "423-883-7920"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Village Personal Care Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakewood Village Personal Care Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fort Worth Psychworks, PLLC
• Fort Worth Radiology, PLLC
• Fort Worth Recovery LLC
• Fort Worth Rehab Group
• Fort Worth Senior Care, LLC (Christian Care Outpatient Therapy)
• Fort Worth Skilled Care, LLC (Immanuels Healthcare)
• Fort Worth Sleep Labs
• Fort Worth Sleep LLC
• Fort Worth Smile Studio P.L.L.C.
• Fort Worth Smilebar PLLC (Smile Ninja Dental)

• Physical Disabilities Residential Treatment Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Disabilities Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.