GOLDEN TRIANGLE LIVING CENTERS, INC. (NPI# 1407071723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407071723 |
Entity Type | Organization |
Organization Name | GOLDEN TRIANGLE LIVING CENTERS, INC. |
Other Organization Name | JERRY LIVING CENTER |
Practice Address |
4415 Jerry Dr Beaumont TX 77703-1923 |
Mailing Address |
715 Main St Pineville LA 71360-6937 |
Practice Telephone | 4098324112 |
Enumeration Date | 2007-04-13 |
Last Update Date | 2020-08-22 |
Authorized Official Name | JAMES E. RICHARDSON (C.E.O.) |
Authorized Official Telephone | 3184456470 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Jerry Living Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013132331 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 411 5th Ave, Port Arthur, TX 77642-3389 | 2007-04-13 |
1598980815 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 11510 Loop Rd, Beaumont, TX 77713-8664 | 2007-04-13 |
1104041524 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 9604 Meadowick Dr., Beaumont, TX 77706 | 2007-04-13 |
1639394950 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 10980 Pine Haven St, Beaumont, TX 77713-8700 | 2007-04-13 |
1801010566 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 5010 Ada St, Beaumont, TX 77708-4411 | 2007-04-12 |
1891919551 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 1682 Huntsman St, Orange, TX 77632-1848 | 2007-04-12 |
1124242268 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2810 Sheridan Ln, Port Arthur, TX 77640-2644 | 2007-04-12 |
1932323094 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 1309 Nottingham Dr, Orange, TX 77632-0449 | 2007-04-12 |
1083838742 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 1924 Thousand Oaks Dr, Orange, TX 77632-1215 | 2007-04-12 |
1720203045 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 5125 Mcanelly Dr, Beaumont, TX 77708-1901 | 2007-04-13 |
Street Address |
4415 JERRY DR |
City | BEAUMONT |
State | TX |
Zip Code | 77703-1923 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558768457 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4415 Jerry Dr, Beaumont, TX 77703-1923 | 2014-11-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548687684 | Christie N Beaugh | Counselor | 2574 North 11th Street, Beaumont, TX 77703 | 2014-03-26 |
1366728040 | Beaumont Orthodontic Specialists | Dentist | 3954 Eastex Freeway, Beaumont, TX 77703 | 2011-10-26 |
1033395660 | Danari, Inc | Durable Medical Equipment & Medical Supplies | 2190 Eastex Freeway, Beaumont, TX 77703 | 2008-01-14 |
1801091848 | Catholic Charities of Southeast Texas | Counselor | 2780 Eastex Freeway, Beaumont, TX 77703 | 2007-06-19 |
1487874400 | Joseph W Provo IIi | Dentist | 1460 Ih 10 East, Suite A, Beaumont, TX 77703 | 2007-05-01 |
1023134608 | Assisted Living Concepts Inc | Assisted Living Facility | 2910 Toccoa Road, Beaumont, TX 77703 | 2007-03-22 |
1134233059 | Golden Traingle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 4415 Jerry, Beaumont, TX 77703 | 2006-08-18 |
1225142144 | Golden Triangle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 6270 Carnation Dr, Beaumont, TX 77703 | 2006-08-18 |
1760588123 | Patrick Joseph Concannon | Radiologic Technologist | 2002 Holcombe Blvd, Houston, TX 77703 | 2006-09-15 |
1487214987 | Edalynn Roper | Home Health Aide | 4885 Detroit St, Beaumont, TX 77703-1416 | 2019-06-17 |
Find all providers in zip 77703 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598980815 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 11510 Loop Rd, Beaumont, TX 77713-8664 | 2007-04-13 |
1104041524 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 9604 Meadowick Dr., Beaumont, TX 77706 | 2007-04-13 |
1639394950 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 10980 Pine Haven St, Beaumont, TX 77713-8700 | 2007-04-13 |
1801010566 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 5010 Ada St, Beaumont, TX 77708-4411 | 2007-04-12 |
1518089739 | Educare Comm Living Corp Texas | Intermediate Care Facility, Mentally Retarded | 9165 Landis Dr, Beaumont, TX 77707-1245 | 2007-04-06 |
1942321385 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 3550 Austin St, Beaumont, TX 77706-3004 | 2007-04-03 |
1871614222 | Educare Comm Living Corp Texas | Intermediate Care Facility, Mentally Retarded | 5155 Cambridge Dr, Beaumont, TX 77707-2043 | 2007-04-03 |
1073634432 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 7585 San Diego St, Beaumont, TX 77708-2305 | 2007-04-03 |
1427162346 | Golden Triangle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 5010 Ada, Beaumont, TX 77706 | 2006-08-18 |
1134233059 | Golden Traingle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 4415 Jerry, Beaumont, TX 77703 | 2006-08-18 |
Find all providers in BEAUMONT |
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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.