RED BEARD LLC (NPI# 1235668625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235668625 |
| Entity Type | Organization |
| Organization Name | RED BEARD LLC |
| Other Organization Name | COUNTRY MANOR ASSISTED LIVING |
| Practice Address |
265 County Road 613 Dayton TX 77535 |
| Mailing Address |
265 County Road 613 Dayton TX 77535-4325 |
| Practice Telephone | (936) 258-6803 |
| Mailing Telephone | 9362586803 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Authorized Official Name | REBECCA JOHNSON (OWNER/MANAGER) |
| Authorized Official Telephone | 9367760703 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS DEPARTMENT OF AGING | 310400000X | 01 |
| Other Name | Type Code |
|---|---|
| Country Manor Assisted Living | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | RED BEARD LLC | 208 Vine St, Kelso, WA 98626 |
| Colorado Business Entities | Red Beard LLC | 463 Pine Glade Rd., Nederland, CO 80466 |
| Street Address |
265 COUNTY ROAD 613 |
| City | DAYTON |
| State | TX |
| Zip Code | 77535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063063063 | Patsy A Conner | Technician | 101 Pine Place Street, Dayton, TX 77535 | 2019-09-23 |
| 1851949002 | Michele Lee Northrup | Pharmacist | 108 N Main, Ste B, Dayton, TX 77535 | 2019-08-30 |
| 1548761257 | Yolanda Tillis | Contractor | 604 Hope Street, Dayton, TX 77535 | 2018-02-27 |
| 1235560541 | Five Star Care Inc. | Pharmacy | 108-b North Main, Dayton, TX 77535 | 2013-12-12 |
| 1124224894 | Shannon T. Boyer | Psychologist | 106 S Cleveland St, Dayton, TX 77535 | 2007-06-21 |
| 1497888721 | Simmons Chiropractic and Wellness Center, P.C. | Chiropractor | 108 Sterling, Dayton, TX 77535 | 2007-03-14 |
| 1740235118 | Redman Family Practice Clinic | Family Medicine | 107 N Winfree, Dayton, TX 77535 | 2006-05-24 |
| 1831399492 | Dayton Isd | Local Education Agency (LEA) | 100 Cherry Creek Rd, Dayton, TX 77535-1301 | 2007-07-23 |
| 1215374608 | Todd Puckett | Counselor | 6 Skylark St, Dayton, TX 77535-1538 | 2013-05-27 |
| 1295168219 | Serenity's Home Care | Custodial Care Facility | 1407 Beauty St, Dayton, TX 77535-1605 | 2013-08-13 |
| Find all providers in zip 77535 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114470572 | Brighter Days Assisted Living | Assisted Living Facility | 406 E Clayton St, Dayton, TX 77535-2320 | 2016-08-02 |
| 1780929810 | Dayton Tarkington Community Center, Inc. | Assisted Living Facility | 17019 Highway 321, Dayton, TX 77535-5816 | 2012-11-29 |
| 1366790529 | The Cottages of Clayton, Inc. | Assisted Living Facility | 8212 N Main St, Dayton, OH 45415-1641 | 2012-08-20 |
| 1992006985 | Brookdale Senior Living Communities Inc | Assisted Living Facility | 3839 Indian Ripple Rd, Dayton, OH 45440-3468 | 2010-11-08 |
| 1366742520 | Pram/singing Woods Te, LLC | Assisted Living Facility | 140 E Woodbury Dr, Dayton, OH 45415-2841 | 2010-10-21 |
| 1891028726 | Ansa Consultants, Inc. | Assisted Living Facility | 401 Ridge Rd Ste 1, Dayton, NJ 08810-3300 | 2009-09-10 |
| 1598894164 | Hearth & Home Assisted Living | Assisted Living Facility | 55 Great Hill Drive, Dayton, OH 45414 | 2007-03-02 |
| 1528104049 | 10wp Inc | Assisted Living Facility | 10 Wilmington Ave, Dayton, OH 45420-1877 | 2007-01-30 |
| 1629062310 | The Suites At Walnut Creek | Assisted Living Facility | 2501 Keystone Club Dr, Dayton, OH 45439-4223 | 2005-09-08 |
| 1578917670 | Ahf Ohio, Inc. | Assisted Living Facility | 264 Wilmington Ave, Dayton, OH 45420-1989 | 2016-04-15 |
| Find all providers in DAYTON | ||||
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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.