SOUTHWEST LTC TEMPLE LLC (NPI# 1639560337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639560337 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST LTC TEMPLE LLC |
| Other Organization Name | TEMPLE MANOR NURSING HOME |
| Practice Address |
100 West Green Ave Temple OK 73568 |
| Mailing Address |
1518 Legacy Dr Suite 110 Frisco TX 75034-6038 |
| Practice Telephone | 5803426228 |
| Mailing Telephone | 4699166100 |
| Mailing Fax Number | 4699166105 |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-19 |
| Authorized Official Name | RONALD R PAYNE (CEO) |
| Authorized Official Telephone | 4699166100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200102030A | 05 |
| Other Name | Type Code |
|---|---|
| Temple Manor Nursing Home | Doing Business As Name - Organization |
| Street Address |
100 WEST GREEN AVE |
| City | TEMPLE |
| State | OK |
| Zip Code | 73568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407040595 | Temple Public Schools | Local Education Agency (LEA) | 206 School Road, Temple, OK 73568 | 2007-08-31 |
| 1053317107 | Psg Temple LLC | Skilled Nursing Facility | 100 Green Ave, Temple, OK 73568 | 2005-06-23 |
| 1437372596 | Andrea Marie Rendina | Occupational Therapy Assistant | 100 Green Ave, Temple, OK 73568 | 2007-04-10 |
| 1962617563 | Tri County Elderly Nutrition Program | Home Delivered Meals | 104 S Commercial, 104 S Commercial, Temple, OK 73568-0000 | 2007-05-14 |
| 1629113105 | Haley Drug | Pharmacist | 102 S Commercial St, Temple, OK 73568-0130 | 2007-02-21 |
| 1568839389 | Temple Public School | Speech-Language Pathologist | 206 School Rd, Temple, OK 73568-0400 | 2015-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
| 1548868664 | Michelle Villarreal | Counselor | 4720 Box Canyon Dr, Temple, TX 76502-7311 | 2020-10-12 |
| 1003423559 | Jennifer Annette Davis | Registered Nurse | 330 Harvest Mdw, Temple, TX 76502-5060 | 2020-09-29 |
| 1669089421 | Heather Ann Votion | Nurse Practitioner | 4501 S General Bruce Dr Ste 75, Temple, TX 76502-1466 | 2020-09-25 |
| 1992310007 | Dena Frances Deweese | Licensed Vocational Nurse | 705 Filly Ln, Temple, TX 76504-4951 | 2020-09-15 |
| 1710592001 | Shirley Holloway | Psychologist | 709 Brazos Dr, Temple, TX 76504-4924 | 2020-09-13 |
| 1831702273 | Maria De La Luz Hernandez | Nurse Practitioner | 507 Marlandwood Rd Apt 1121, Temple, TX 76502-3695 | 2020-08-25 |
| 1134732787 | Rebecca Taylor Battleson | Nurse Practitioner | 764 Marlandwood Rd Apt 515, Temple, TX 76502-3654 | 2020-08-24 |
| 1437761319 | Erin Lee Kern | Dentist | 3550 S General Bruce Dr Ste D103, Temple, TX 76504-5138 | 2020-08-20 |
| 1386255586 | Chelsey Werchan | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 22103e, Temple, TX 76508-0001 | 2020-08-11 |
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| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
| 1639691603 | Scott & White Continuing Care Hospital | Skilled Nursing Facility | 546 N Kegley Rd Fl 2, Temple, TX 76502-4069 | 2017-07-12 |
| 1174678866 | Pm Management-temple Nc I LLC | Skilled Nursing Facility | 2505 S 37th St, Temple, TX 76504-7103 | 2007-01-24 |
| 1205996832 | Pm Management-temple Nc II LLC | Skilled Nursing Facility | 512 Draper Dr, Temple, TX 76504-2911 | 2006-12-12 |
| 1336209964 | Pm Management-temple Nc IIi LLC | Skilled Nursing Facility | 1700 Marlandwood Rd, Temple, TX 76502-2842 | 2006-12-12 |
| 1366502213 | Pm Management-temple Nc Iv LLC | Skilled Nursing Facility | 1511 Marlandwood Rd, Temple, TX 76502-3338 | 2006-12-11 |
| 1124038690 | Cornerstone Gardens L L P | Skilled Nursing Facility | 763 Marlandwood Rd, Temple, TX 76502-3573 | 2006-08-08 |
| 1346292638 | Slp Regency Manor LLC | Skilled Nursing Facility | 3011 W Adams Ave, Temple, TX 76504-2873 | 2006-05-16 |
| 1619969417 | Eastland Memorial Hospital District | Skilled Nursing Facility | 1802 S 31st St, Temple, TX 76504-6712 | 2005-08-17 |
| 1588664866 | State of Texas Veterans Land Board | Skilled Nursing Facility | 1424 Martin Luther King Jr Ln, Temple, TX 76504-5941 | 2005-07-28 |
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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.