WALLACE PLACE IN THE PINES (NPI# 1194382374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194382374 |
Entity Type | Organization |
Organization Name | WALLACE PLACE IN THE PINES |
Other Organization Name | WALLACE PLACE IN THE PINES |
Practice Address |
1706 Davis Ave Livingston TX 77351-2004 |
Practice Telephone | 9362234542 |
Mailing Telephone | 9362234542 |
Enumeration Date | 2019-05-23 |
Last Update Date | 2019-06-04 |
Authorized Official Name | BARBARA ANN WALLACE (OWNER) |
Authorized Official Telephone | 9366625617 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 102X00000X | Poetry Therapist | Behavioral Health & Social Service Providers | ||
N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Wallace Place In The Pines | Former Legal Business Name - Organization |
Street Address |
1706 DAVIS AVE |
City | LIVINGSTON |
State | TX |
Zip Code | 77351-2004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881252765 | B&g Family Dentistry Pllc | Clinic/Center | 402 S Washington Ave, Livingston, TX 77351 | 2019-06-05 |
1518431907 | Clinton Jarell Collins | Occupational Therapist | 1620 Us-59 N, Livingston, TX 77351 | 2019-01-18 |
1205318417 | Christopher Hern | Nurse Practitioner | 1717 Us-59 Loop N, Livingston, TX 77351 | 2018-09-04 |
1831566520 | Susan Michelle Brownfield | Occupational Therapist | 1620 Old Us Hwy 59, Livingston, TX 77351 | 2015-08-28 |
1346643624 | Jigneshkumar Parmar | Dentist | 1774 Us 190 West, Livingston, TX 77351 | 2014-10-01 |
1063827954 | Faith Whatley-torres | Behavioral Analyst | 144 Branding Iron, Livingston, TX 77351 | 2014-06-30 |
1427481126 | Mary Elizabeth Kuruvilla | Dentist | 184 Ashton Bend, Livingston, TX 77351 | 2013-08-16 |
1255772778 | Waleed Khaled Ahmad | Dentist | 117 Southpoint Lane, Suite 400, Livingston, TX 77351 | 2013-07-12 |
1053750679 | Jacquelyn Y Flores | Dentist | 1114 N. Washingtion Ave., Livinston, TX 77351 | 2013-06-17 |
1750725131 | Womans Clinic At Livingston Pllc | Radiology | 111 Emergency Dr., Ste C, Livingston, TX 77351 | 2013-04-29 |
Find all providers in zip 77351 |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700033214 | New Life Supportive Living, LLC. | Community Based Residential Treatment Facility, Mental Illness | 201 Clark St, Livingston, TN 38570-1608 | 2008-08-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538778410 | Inspired Community Living | Community Based Residential Treatment Facility, Mental Illness | 1108 Millspaugh St, San Angelo, TX 76901-2342 | 2020-07-27 |
1265058143 | Bam House | Community Based Residential Treatment Facility, Mental Illness | 9710 Military Pkwy Apt 136, Dallas, TX 75227-4801 | 2020-06-17 |
1699394320 | Thaddeus Gibson | Community Based Residential Treatment Facility, Mental Illness | 15638 Western Skies Dr, Houston, TX 77086-1169 | 2020-04-13 |
1346875705 | Grace Caring Angels Inc. | Community Based Residential Treatment Facility, Mental Illness | 11515 Chariot Dr, Stafford, TX 77477-1214 | 2020-03-05 |
1992340541 | Abegail Human Services | Community Based Residential Treatment Facility, Mental Illness | 230 Hackney Dr, Waxahachie, TX 75165-1202 | 2019-11-07 |
1073098075 | Expert Living Services Inc | Community Based Residential Treatment Facility, Mental Illness | 17014 Blue Mist Dr, Sugar Land, TX 77498-1957 | 2018-09-26 |
1760961734 | Sharion Lenese White | Community Based Residential Treatment Facility, Mental Illness | 12514 Berry Laurel Lane, Houston, TX 77014 | 2018-08-10 |
1356837934 | X'zavier O Payne | Community Based Residential Treatment Facility, Mental Illness | 420 N State Highway 360 Apt 2214, Mansfield, TX 76063-8716 | 2018-07-06 |
1972003192 | Ateam & Associates, LLC | Community Based Residential Treatment Facility, Mental Illness | 7 Supiro Dr, Manvel, TX 77578-3378 | 2018-02-14 |
1891234134 | Graceland Personal Care Homes, Inc | Community Based Residential Treatment Facility, Mental Illness | 2625 County Road 302, Carthage, TX 75633-4103 | 2017-02-20 |
Find all providers with the same taxonomy |
City | LIVINGSTON |
Zip Code | 77351 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.