ST. NICHOLAS OPERATIONS LLC (NPI# 1841558582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841558582 |
| Entity Type | Organization |
| Organization Name | ST. NICHOLAS OPERATIONS LLC |
| Practice Address |
4612 Heatherbrook Dr Dallas TX 75244-7634 |
| Mailing Address |
11727 S Sam Houston Pkwy W Suite D Houston TX 77031-2342 |
| Practice Telephone | 7132717777 |
| Practice Fax Number | 7132718585 |
| Mailing Telephone | 7132717777 |
| Mailing Fax Number | 7132718585 |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |
| Authorized Official Name | JOHN BENJAMIN PEAKES (MANAGER) |
| Authorized Official Telephone | 7132717777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639474869 | St. Nicholas Operations LLC | Intermediate Care Facility, Mentally Retarded | 11727 S Sam Houston Pkwy W, Suite D, Houston, TX 77031-2342 | 2011-01-19 |
| Street Address |
4612 HEATHERBROOK DR |
| City | DALLAS |
| State | TX |
| Zip Code | 75244-7634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316561194 | Kevin Goodnight | Behavioral Analyst | 4230 Sigma Road, Dallas, TX 75244 | 2020-06-08 |
| 1851941413 | Medi-wheels, LLC | Durable Medical Equipment & Medical Supplies | 5005 Lbj Freeway, Ste. 840, Dallas, TX 75244 | 2019-09-16 |
| 1972157436 | Samantha Lograsso | Nurse Practitioner | 4055 Valley View Ln Suite 400, Dallas, TX 75244 | 2019-08-01 |
| 1205313780 | Cherae Ashland Burton | Licensed Vocational Nurse | 4099 Mcewen Rd., Farmers Branch, TX 75244 | 2018-07-26 |
| 1700383197 | Melissa Fitts | Behavioral Analyst | 13604 Midway Rd. #180, Farmers Branch, TX 75244 | 2018-04-11 |
| 1932607983 | Vcphcs, Lp | Clinic/Center | 5001 Spring Valley Road, Suite 600 East, Dallas, TX 75244 | 2018-01-24 |
| 1518406636 | Gentech Laboratories LLC | Clinical Medical Laboratory | 4403 N. Beltwood Parkway, Suite 300, Dallas, TX 75244 | 2017-02-22 |
| 1881045680 | Innovative Lifeskills Training Center LLC | Preferred Provider Organization | 5001 Spring Valley, Towers East Ste 400, Dallas, TX 75244 | 2016-06-23 |
| 1376992792 | Lynnlie Tuschoff | Registered Nurse | 4099 Mcewen, Suite 250, Farmers Brach, TX 75244 | 2016-06-07 |
| 1609223072 | Debra Jules | Licensed Vocational Nurse | 4099 Mcewen Road, Dallas, TX 75244 | 2016-05-16 |
| Find all providers in zip 75244 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770107831 | American Roses Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6330 S Lancaster Rd, Dallas, TX 75241-3800 | 2020-06-04 |
| 1841839727 | Bellview Advocacy Project LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14606 Dallas Pkwy Apt 1111, Dallas, TX 75254-7451 | 2019-12-25 |
| 1740832021 | Brittany Dory | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8004 W Virginia Dr Apt 908, Dallas, TX 75237-4425 | 2019-07-16 |
| 1235621368 | Infinite Hope Hcs, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4650 S Hampton Rd Ste 11, Dallas, TX 75232-1066 | 2018-06-04 |
| 1295246916 | Camilla Medina | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 Amos St, Dallas, TX 75212-5202 | 2017-10-20 |
| 1619351665 | Kimberly Hutchings | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9670 Forest Ln Apt 1109, Dallas, TX 75243-8639 | 2015-07-18 |
| 1346620259 | Sherry Clark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7030 Capella Park Ave, Dallas, TX 75236-3003 | 2015-06-05 |
| 1710377726 | U-niq Identity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 917 Fordham Rd, Dallas, TX 75216-6133 | 2015-01-28 |
| 1356747554 | A Su Lado Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Main St Apt 202, Dallas, TX 75202-4300 | 2014-11-15 |
| 1477957405 | Amethyst Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5863 Foxglove Ln, Dallas, TX 75249-1625 | 2014-10-20 |
| Find all providers in DALLAS | ||||
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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.