HARBOR LAKES SCC LLC (NPI# 1902185903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902185903 |
| Entity Type | Organization |
| Organization Name | HARBOR LAKES SCC LLC |
| Other Organization Name | SENIOR CARE OF HARBOR LAKES |
| Practice Address |
1300 E 2nd St Granbury TX 76048-1496 |
| Mailing Address |
600 N Pearl St Ste 1050 Dallas TX 75201-7495 |
| Practice Telephone | 8174083800 |
| Practice Fax Number | 8175730165 |
| Mailing Telephone | 2142527600 |
| Mailing Fax Number | 2142527704 |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | MICHAEL BEAL (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2142527600 |
| 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 |
|---|---|---|---|
| TX | 001019881 | 05 |
| Other Name | Type Code |
|---|---|
| Senior Care of Harbor Lakes | Doing Business As Name - Organization |
| Street Address |
1300 E 2ND ST |
| City | GRANBURY |
| State | TX |
| Zip Code | 76048-1496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326523135 | Matthew Dumican | Speech-Language Pathologist | 1300 E 2nd St, Granbury, TX 76048-1496 | 2018-09-27 |
| 1992285910 | Kristin Nicole Hubbard | Physical Therapy Assistant | 1300 E 2nd St, Granbury, TX 76048-1496 | 2018-08-20 |
| 1699255851 | Alexandra Shea | Occupational Therapy Assistant | 1300 E 2nd St, Granbury, TX 76048-1496 | 2018-08-17 |
| 1871073031 | Christine Marie Follis | Occupational Therapy Assistant | 1300 E 2nd St, Granbury, TX 76048-1496 | 2018-08-17 |
| 1114407376 | Dale Wayne Polk | Physical Therapy Assistant | 1300 E 2nd St, Granbury, TX 76048-1496 | 2018-08-17 |
| 1568942639 | Elizabeth Blair Christy | Occupational Therapist | 1300 E 2nd St, Granbury, TX 76048-1496 | 2018-08-17 |
| 1801376918 | Karen Lynn Finch | Physical Therapy Assistant | 1300 E 2nd St, Granbury, TX 76048 | 2018-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689213415 | Tena Lee Wood I | Licensed Practical Nurse | 302 S. Crites Granbury Tx. 76048, 302 S. Crites Granbury Tx. 76048, Granbury, TX 76048 | 2019-12-26 |
| 1811456593 | Laura Nicole Graham | Counselor | 2101 West Pearl Street, Granbury, TX 76048 | 2019-03-13 |
| 1477000974 | Globalrehab - Fort Worth, Lp | Rehabilitation Hospital | 805 Hill Blve, Ste 109, Granbury, TX 76048 | 2016-09-01 |
| 1780130245 | Rachel Diane Rouse | Counselor | 1903 W Pearl Street, Granbury, TX 76048 | 2016-08-25 |
| 1477946648 | Adriana Brown | Nurse Practitioner | 805 Hill Blvd., #104, Granbury, TX 76048 | 2015-03-12 |
| 1407261233 | Rogers King Coleman | General Practice | 1411 Crawford Street, Granbury, TX 76048 | 2014-07-01 |
| 1891115176 | Trinity Nursing and Rehabilitation of Granbury, Lp | Skilled Nursing Facility | 600 Reunion Court, Granbury, TX 76048 | 2014-04-24 |
| 1639507122 | Kayelen Helton | Counselor | 807 Paluxy Road, Granbury, TX 76048 | 2013-10-22 |
| 1013257799 | Pecan Valley Mhmr Region | Counselor | 2101 W. Pearl St., Granbury, TX 76048 | 2013-02-18 |
| 1114240223 | Talbot Green Mccormick Jr. | General Practice | 2306 Cologne Dr., Granbury, TX 76048 | 2010-03-03 |
| Find all providers in zip 76048 | ||||
| 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 |
|---|---|---|---|---|
| 1891115176 | Trinity Nursing and Rehabilitation of Granbury, Lp | Skilled Nursing Facility | 600 Reunion Court, Granbury, TX 76048 | 2014-04-24 |
| 1558539205 | Mspf II Granbury O.e., L.p. | Skilled Nursing Facility | 1300 2nd St, Granbury, TX 76048-1496 | 2008-02-15 |
| 1033169636 | Trinity Mission of Granbury, LLC | Skilled Nursing Facility | 600 Reunion Ct, Granbury, TX 76048-1610 | 2006-05-12 |
| 1205894185 | Creative Solutions In Healthcare At Granbury, LLC | Skilled Nursing Facility | 301 S Park St, Granbury, TX 76048-1800 | 2006-05-02 |
| 1023002706 | Southwest Ltc--granbury, Ltd. | Skilled Nursing Facility | 2124 Paluxy Hwy, Granbury, TX 76048-5530 | 2005-09-08 |
| 1285043190 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 2124 Paluxy Hwy, Granbury, TX 76048-5530 | 2014-08-05 |
| 1639423270 | Granbury Snf LLC | Skilled Nursing Facility | 2124 Paluxy Hwy, Granbury, TX 76048-5530 | 2012-11-05 |
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| 1821601691 | Altamira Healthcare LLC | Skilled Nursing Facility | 200 Carla St, Zapata, TX 78076-3114 | 2020-08-31 |
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| 1972112464 | The Brixton At Horseshoe Bay | Skilled Nursing Facility | 15101 West Fm 2147, Horseshoe Bay, TX 78657 | 2020-07-30 |
| 1558984278 | Slp Johnson City LLC | Skilled Nursing Facility | 206 Haley Rd, Johnson City, TX 78636-4617 | 2020-05-28 |
| 1073136149 | Continuum Rehab Group | Skilled Nursing Facility | 3326 Burgoyne St # 1432, Dallas, TX 75233-1304 | 2020-05-24 |
| 1750904264 | Frank Villanueva | Skilled Nursing Facility | 711 W Broadway St, Denver City, TX 79323-3000 | 2020-05-19 |
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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.