Advanced Living Technologies Inc

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

117933 Issued in TX

Legal business name

ADVANCED LIVING TECHNOLOGIES INC

Doing business as

Country Careplex

Practice address

1181 N Williamson St
Giddings, TX 78942-1213

Phone

(979) 542-3611

Fax

(979) 542-1365

NPI assigned

Apr 13, 2007

Last updated

Nov 2, 2012By 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. Paul Gray

Title

President

Phone

(512) 345-0700

Specialties & licenses 1

Addresses

Other names 1

• COUNTRY CAREPLEX Doing business as

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1962626432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 MORADO CIR",
            "address_2": "SUITE 3 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595696",
            "telephone_number": "512-345-0700",
            "fax_number": "888-368-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 N WILLIAMSON ST",
            "city": "GIDDINGS",
            "state": "TX",
            "postal_code": "789421213",
            "telephone_number": "979-542-3611",
            "fax_number": "979-542-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED LIVING TECHNOLOGIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-345-0700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "TX",
            "license": "117933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTRY CAREPLEX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Chonaworah Adisam
• Corinne Theresa Alvarez-Sanders, PH.D.
• Amazing Grit & Grace, LLC
• Amy J .Jatzlau, M.D., P.a.
• Jerry Anderson, PH.D.
• B & M Ambulance Service Inc (Lee County EMS)

• Pediatric Skilled Nursing Facility in Giddings, TX
• Providers in Giddings, TX by specialty
• Pediatric Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.