ANNADALE MANOR (NPI# 1790834323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790834323 |
| Entity Type | Organization |
| Organization Name | ANNADALE MANOR |
| Practice Address |
10702 County Road 1300 Wolfforth TX 79382-7006 |
| Practice Telephone | 8068669186 |
| Mailing Telephone | 8068669186 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS AMBER FORD (CASE MANAGER) |
| Authorized Official Telephone | 8068669186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116184 | TX | Residential Treatment Facilities |
| Street Address |
10702 COUNTY ROAD 1300 |
| City | WOLFFORTH |
| State | TX |
| Zip Code | 79382-7006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952596009 | Wolfforth I Enterprises, LLC | Assisted Living Facility | 301 E 5th St, Wolfforth, TX 79382 | 2007-09-12 |
| 1992998090 | Juan Jose Vuelvas | Pediatrics | 502 East Highway 62/82, Wolfforth, TX 79382 | 2007-08-22 |
| 1285782789 | Dominguez J-mar Ltd | Durable Medical Equipment & Medical Supplies | 207 Loop 193, Wolfforth, TX 79382 | 2007-01-08 |
| 1003849795 | City of Wolfforth | Emergency Medical Technician, Paramedic | 305 Cedar Ave, Wolfforth, TX 79382 | 2006-07-08 |
| 1215919634 | Niska Aaron Blevins | Radiology | 929 Cantebury Ave, Wolfforth, TX 79382 | 2005-11-20 |
| 1376688721 | Frenship Isd | Local Education Agency (LEA) | 500 Main Street, Wolfforth, TX 79382-0100 | 2007-02-21 |
| 1396298279 | Sydni Sprecher | Nurse Practitioner | 502 E Highway 62 # 82, Wolfforth, TX 79382-2241 | 2016-07-27 |
| 1124492434 | Ashlea Freeman | Registered Nurse | 912 11th St, Wolfforth, TX 79382-2408 | 2015-11-24 |
| 1851957591 | Delena Martinez | Nurse Practitioner | 1603 Corpus Ave, Wolfforth, TX 79382-2847 | 2019-05-17 |
| 1194943647 | Vanessa Lee Sandoval | Speech-Language Pathologist | 501 7th St, Wolfforth, TX 79382-2934 | 2007-04-22 |
| Find all providers in zip 79382 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581782 | Joyful Psalm | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1354 Ravenwood Ct, Crowley, TX 76036-3472 | 2020-09-04 |
| 1790394161 | Modern Vintage Residential Care, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4015 Alexis Tate Cir, Missouri City, TX 77459-5039 | 2020-07-30 |
| 1285253856 | 1 Care Premier Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 340 N Sam Houston Pkwy E Ste A247, Houston, TX 77060-3305 | 2020-04-13 |
| 1568093888 | James Micah Howard | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11911 Lakewood Trl, Tomball, TX 77377-8563 | 2020-01-27 |
| 1518507110 | Gems Residence LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5810 Liverpool St, Aubrey, TX 76227-1909 | 2020-01-10 |
| 1366081812 | Abundant Care Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Maxfield St, Waco, TX 76705-2967 | 2020-01-02 |
| 1306487426 | Fort Healthcare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5833 Oakbend Trail, #200, Fort Worth, TX 76132-3900 | 2019-09-30 |
| 1144877481 | Boniswa Portia Maduna | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8000 Cook Rd Apt 1109, Houston, TX 77072-3939 | 2019-08-21 |
| 1871148171 | Kenneth Allen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 135 E Menefee St, Lufkin, TX 75901-4701 | 2019-08-05 |
| 1124673553 | 1st A & M Healthcare Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 504 Spicewood Dr, Desoto, TX 75115-1485 | 2019-08-02 |
| 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.