IMPERIAL ADULT CARE HOME LLC (NPI# 1528679461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528679461 |
| Entity Type | Organization |
| Organization Name | IMPERIAL ADULT CARE HOME LLC |
| Practice Address |
1355 Ventura Dr Rockwall TX 75087-2492 |
| Practice Telephone | 2144447406 |
| Practice Fax Number | 4697193685 |
| Mailing Telephone | 2144447406 |
| Mailing Fax Number | 4697193685 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | SAKWE BONGO MCDONALD (OWNER) |
| Authorized Official Telephone | 2144447406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
1355 VENTURA DR |
| City | ROCKWALL |
| State | TX |
| Zip Code | 75087-2492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104452309 | Schweers Dental Pllc | Clinic/Center | 3005 N Goliad St., Suite 110, Rockwall, TX 75087 | 2020-03-19 |
| 1467091611 | Elsa Varughese | Nurse Practitioner | 414 Garrett Dr, Rockwall, TX 75087 | 2020-01-04 |
| 1578105391 | Jaya Raji Mathai | Psychiatry & Neurology | 2249 Ridge Rd., Rockwall, TX 75087 | 2019-10-14 |
| 1104326784 | Eunice B Ontita | Nurse Practitioner | 601 White Hills Dr., Suite 100, Rockwall, TX 75087 | 2018-02-20 |
| 1053811885 | Emelda Fehnyui Ndinjiakat | Licensed Vocational Nurse | 610 Louder Way, Fate, TEXAS 75087 | 2018-02-19 |
| 1588163885 | January Lauren Green | Nurse Practitioner | 6800 Heritage Parkway, Suite 201, Rockwall, TX 75087 | 2018-02-02 |
| 1093268328 | Anouk Family Chiropractic, Pllc | Chiropractor | 2555 Ridge Rd #150, Rockwall, TX 75087 | 2016-08-03 |
| 1962858134 | Katherine L. Crane | Counselor | 302 W. Kaufman St., Rockwall, TX 75087 | 2016-05-06 |
| 1669841102 | Richard Carroll Smith | Obstetrics & Gynecology | 2120 Clubview, Rockwall, TX 75087 | 2015-09-15 |
| 1033598032 | Michelle Knight | Massage Therapist | 767 Justin Rd, Rockwall, TX 75087 | 2015-05-22 |
| Find all providers in zip 75087 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538483 | Alejandra Melendez | Custodial Care Facility | 160 Santa Paula Dr, El Paso, TX 79927-1466 | 2020-11-04 |
| 1962001750 | Geov Divine Healthcare Services Inc. | Custodial Care Facility | 230 Darby Trails Dr, Sugar Land, TX 77479-5243 | 2020-10-22 |
| 1306444799 | St Leo Healthcare Services Inc | Custodial Care Facility | 4338 Berry Bend Ln, Richmond, TX 77406-7224 | 2020-10-16 |
| 1609473065 | Business Minds of Houston, LLC | Custodial Care Facility | 6102 Stonebury Ct, Sugar Land, TX 77479-5487 | 2020-10-07 |
| 1831704311 | Holistic Group LLC | Custodial Care Facility | 510 Cassia Way, Arlington, TX 76002-4520 | 2020-09-11 |
| 1619581170 | Unconditional Love Adult Family Homes | Custodial Care Facility | 3906 Waterproof, Killeen, TX 76549-4404 | 2020-09-02 |
| 1871105924 | Beezway Inc | Custodial Care Facility | 6100 Verandas Cir Apt 837, Fort Worth, TX 76132-4166 | 2020-08-20 |
| 1972112266 | Texas Pro Homecare Inc. | Custodial Care Facility | 2706 Seabiscuit Road, Celina, TX 75009 | 2020-07-23 |
| 1598374787 | Anapa Healthcare Services LLC | Custodial Care Facility | 22430 Rustic Meadow Ct, Katy, TX 77494-8247 | 2020-07-23 |
| 1336766336 | Living Faith Community Home, Inc. | Custodial Care Facility | 10735 Braes Forest Dr, Houston, TX 77071-1501 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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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.