Elite LTC Properties of Bertram LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ELITE LTC PROPERTIES OF BERTRAM LLC

Practice address

540 E Highway 29
Bertram, TX 78605-4473

Phone

(512) 355-2116

NPI assigned

Apr 28, 2010

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

Locations

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
• Dungarvin Texas, LLC
• Dungarvin Texas, LLC
• 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.