CLEBURNE COUNTRY LLC (NPI# 1174769483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174769483 |
| Entity Type | Organization |
| Organization Name | CLEBURNE COUNTRY LLC |
| Other Organization Name | SUMMER PLACE NURSING & REHABILITATION |
| Practice Address |
2485 S. Major Drive Beaumont TX 77707-5019 |
| Mailing Address |
4500 Main Ave Groves TX 77619-4712 |
| Practice Telephone | 4098614611 |
| Mailing Telephone | 4099620910 |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2009-02-03 |
| Authorized Official Name | MR. JAMES W MOORE SR. (PRESIDENT) |
| Authorized Official Telephone | 4099620910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| SUMMER PLACE NURSING & REHABILITATION | Doing Business As Name - Organization |
| Street Address |
2485 S. MAJOR DRIVE |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77707-5019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437718004 | Kelsey Marie Burt | Speech-Language Pathologist | 87 I-10, Beaumont, TX 77707 | 2019-06-07 |
| 1245898808 | Primary Care Anywhere, Pllc | Nurse Practitioner | 4347 Phelan, Suite 101, Beaumont, TX 77707 | 2019-05-30 |
| 1598321663 | Kacy Keitha Priddy | Occupational Therapist | 1846 I-10 S, Suite 102, Beaumont, TX 77707 | 2019-05-14 |
| 1144791963 | Jeffery Ray Manzer | Counselor | 3350 Dowlen Rd Suite J, Beaumont, TX 77707 | 2018-12-06 |
| 1497247217 | Haley Hebert | Speech-Language Pathologist | 87 I 10 N, Suite 225, Beaumont, TX 77707 | 2018-06-06 |
| 1548712383 | Taylor Miguez | Speech-Language Pathologist | 87 I-10 Frontage Rd #225, Beaumont, TX 77707 | 2016-10-27 |
| 1720534043 | Jacie Woodson | Speech-Language Pathologist | 87 I-10 Frontage Rd. 225, Beaumont, TX 77707 | 2016-08-28 |
| 1285187047 | Paula Boudreaux | Speech-Language Pathologist | 87 I-10 Frontage Rd, Suite 225, Beaumont, TX 77707 | 2016-07-28 |
| 1790138568 | Meagan Alyse Hartwick | Speech-Language Pathologist | 87 I-10 Frontage Rd., 225, Beaumont, TX 77707 | 2016-07-18 |
| 1376992578 | Laurie Lynette Jansky | Family Medicine | 3650 Laurel Ave, Beaumont, TX 77707 | 2016-06-08 |
| Find all providers in zip 77707 | ||||
| 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 |
|---|---|---|---|---|
| 1093216988 | Moc Beaumont, LLC | Skilled Nursing Facility | 2665 N 11th St, Beaumont, TX 77703-4605 | 2018-02-26 |
| 1376963785 | Beaumont Manor LLC | Skilled Nursing Facility | 1441 N Michigan Ave, Beaumont, CA 92223-1728 | 2014-04-24 |
| 1750402236 | Ssc Beaumont Green Acres Operating Company LLC | Skilled Nursing Facility | 11025 Old Voth Rd, Beaumont, TX 77713-8613 | 2007-04-03 |
| 1326141557 | Liberty County Hospital District No 1 | Skilled Nursing Facility | 4150 College St, Beaumont, TX 77707-3902 | 2006-09-06 |
| 1699877449 | Hsmtx/lindbergh-beaumont, LLC | Skilled Nursing Facility | 795 Lindbergh Dr, Beaumont, TX 77707 | 2006-09-02 |
| 1689608614 | Buckner Retirement Services, Inc. | Skilled Nursing Facility | 7080 Calder Ave, Beaumont, TX 77706-6052 | 2006-07-10 |
| 1346204633 | Pinnacle Health Facilities of Texas Xi Lp | Skilled Nursing Facility | 4195 Milam St, Beaumont, TX 77707-3918 | 2006-04-13 |
| 1134101553 | Winnie-stowell Hospital District | Skilled Nursing Facility | 1020 S 23rd St, Beaumont, TX 77707-4202 | 2005-11-20 |
| 1598746182 | David Kleis II, LLC | Skilled Nursing Facility | 1665 E 8th St, Beaumont, CA 92223-2512 | 2005-11-09 |
| 1700867389 | David Kleis, Inc. | Skilled Nursing Facility | 1441 Michigan Ave, Beaumont, CA 92223-1728 | 2005-11-09 |
| Find all providers in BEAUMONT | ||||
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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.