A Roosevelt Residential Care

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

A ROOSEVELT RESIDENTIAL CARE

Practice address

5117 Rocky Ridge Rd
Dallas, TX 75241-1023

Phone

(214) 434-1583

NPI assigned

Sep 21, 2022

Organization subpart

No

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

Authorized official

Name

Glaster Wheeler HicksNPI 1790444834

Title

Owner/Manager

Phone

(214) 850-8318

Specialties & licenses 1

Addresses

Other names 1

• A. Roosevelt Residential Care Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glaster Wheeler Hicks

  • Assisted Living Facility
  • Dallas, TX
  • NPI 1790444834
  NPD Authorized official

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1962125302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398706",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753398706",
            "telephone_number": "214-850-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5117 ROCKY RIDGE RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752411023",
            "telephone_number": "214-434-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A ROOSEVELT RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "GLASTER",
        "authorized_official_middle_name": "WHEELER",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "214-850-8318"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A. Roosevelt Residential Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Dallas, TX
• Providers in Dallas, 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 Sep 21, 2022; 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.