Vintage SCC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

VINTAGE SCC LLC

Doing business as

Vintage Health Care Center

Practice address

205 N Bonnie Brae St
Denton, TX 76201-3766

Phone

(940) 373-4766

Fax

(940) 320-6645

NPI assigned

Dec 10, 2008

Last updated

Sep 4, 2020By 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

Jason Price

Title

Senior Vice President

Phone

(949) 436-4343

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vintage Health Care Center Doing business as

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1972748630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BONNIE BRAE ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013766",
            "telephone_number": "940-373-4766",
            "fax_number": "940-320-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BONNIE BRAE ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013766",
            "telephone_number": "940-373-4766",
            "fax_number": "940-320-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE SCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "949-436-4343"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001016908",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vintage Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Denton, TX
• Providers in Denton, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.