LEGACY CARE CENTERS, INC. (NPI# 1114924529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114924529 |
| Entity Type | Organization |
| Organization Name | LEGACY CARE CENTERS, INC. |
| Other Organization Name | SYCAMORE CARE CENTER |
| Practice Address |
921 W Cannon St Fort Worth TX 76104-3026 |
| Mailing Address |
3801 Woodside Dr Arlington TX 76016-3030 |
| Practice Telephone | 8173329261 |
| Practice Fax Number | 8173323035 |
| Mailing Telephone | 8176543042 |
| Mailing Fax Number | 8174463666 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. CHERYL L KILLIAN (PRESIDENT) |
| Authorized Official Telephone | 8176543042 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 112967 | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 4192 | 05 |
| Other Name | Type Code |
|---|---|
| Sycamore Care Center | Doing Business As Name - Organization |
| Street Address |
921 W CANNON ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-3026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619207206 | Pathways Adult Living Inc | Community Based Residential Treatment Facility, Mental Illness | 921 W Cannon St, Fort Worth, TX 76104-3026 | 2010-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| 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 |
|---|---|---|---|---|
| 1467973404 | Moc Fort Worth LLC | Skilled Nursing Facility | 6301 Oakmont Blvd, Fort Worth, TX 76132-2814 | 2017-06-29 |
| 1669929642 | Eastland Memorial Hospital District | Skilled Nursing Facility | 4240 Golden Triangle Boulevard, Fort Worth, TX 76244 | 2016-09-07 |
| 1326594052 | Stockyards Healthcare, Inc. | Skilled Nursing Facility | 6301 Oakmont Boulevard, Fort Worth, TX 76132 | 2016-09-01 |
| 1770972572 | Dallas County Hospital District | Skilled Nursing Facility | 7021 Bryant Irvin Rd, Fort Worth, TX 76132-4243 | 2015-01-15 |
| 1497172514 | Stephens Memorial Hospital District | Skilled Nursing Facility | 306 W 7th Strret Suite 430, Fort Worth, TX 76102 | 2014-03-26 |
| 1245662675 | Performance Care Centers LLC | Skilled Nursing Facility | 7021 Bryant Irvin Road, Fort Worth, TX 76132 | 2013-08-08 |
| 1881968808 | Fw Senior Community Ltd Co | Skilled Nursing Facility | 4600 Heritage Trace Pkwy, Fort Worth, TX 76244-8900 | 2012-03-08 |
| 1750679098 | Tarrant County Senior Living Center, Inc. | Skilled Nursing Facility | 2501 Museum Way, Fort Worth, TX 76107-3057 | 2011-07-20 |
| 1386949220 | Remarkable Healthcare of Fort Worth, Lp | Skilled Nursing Facility | 6649 North Riverside Drive, Fort Worth, TX 76137 | 2011-01-25 |
| 1679895163 | Decatur Hospital Authority | Skilled Nursing Facility | 850 12th Ave., Fort Worth, TX 76104-2516 | 2010-02-24 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.