Elite LTC Properties of Bertram LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ELITE LTC PROPERTIES OF BERTRAM LLC

Doing business as

Bertram Nursing adn Rehab Center

Practice address

540 E Highway 29
Bertram, TX 78605-4473

Phone

(512) 355-2116

NPI assigned

Apr 28, 2010

Last updated

Apr 28, 2010By 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. Jeffrey A Head

Title

Managing Member

Phone

(817) 992-2028

Specialties & licenses 1

Addresses

Other names 1

• Bertram Nursing adn Rehab Center Doing business as

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1982921151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7429 AIRPORT FWY",
            "city": "RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761186955",
            "telephone_number": "817-595-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E HIGHWAY 29",
            "city": "BERTRAM",
            "state": "TX",
            "postal_code": "786054473",
            "telephone_number": "512-355-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE LTC PROPERTIES OF BERTRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-992-2028",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bertram Nursing adn Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsay Doyal, RN, BSN, IBCLC
• Haley Dueitt, LPC
• Dungarvin Texas, LLC (Bertram Community Residence)
• Dungarvin Texas, LLC (Woodview Community Residence)
• Dungarvin Texas, LLC (Bluebonnet Community Residence)
• Erin Hope Ellett, LPC
• Colin Ferguson
• Laura Fucik
• Jennifer Boehm Gattuso
• Tamera Ann Gibson

• Skilled Nursing Facility in Bertram, TX
• Providers in Bertram, 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 Apr 28, 2010; 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.