GOLD STAR ASSISTED LIVING (NPI# 1396960993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396960993 |
| Entity Type | Organization |
| Organization Name | GOLD STAR ASSISTED LIVING |
| Practice Address |
503 W Highway 243 Canton TX 75103-2113 |
| Mailing Address |
Po Box 1090 Canton TX 75103-7090 |
| Practice Telephone | 9035672762 |
| Practice Fax Number | 9035672237 |
| Mailing Telephone | 9035672762 |
| Mailing Fax Number | 3095672237 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JERRY LYNN TIDWELL (MANAGER) |
| Authorized Official Telephone | 9035672762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 030299 | TX | Nursing & Custodial Care Facilities |
| Street Address |
503 W HIGHWAY 243 |
| City | CANTON |
| State | TX |
| Zip Code | 75103-2113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265095202 | Brandi Jo Foster | Nurse Practitioner | 4437 Etheride Circle, Canton, TX 75103 | 2019-04-16 |
| 1124595087 | Melissa Williams | Nurse Practitioner | 1108 So. Buffalo St, Canton, TX 75103 | 2018-10-30 |
| 1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
| 1568945921 | Kelsey Lauren Nixon | Registered Nurse | 5640 Vzcr 4106, Canton, TX 75103 | 2018-09-12 |
| 1649770496 | Chelsea Boshart | Registered Nurse | 150 Vz Cr 4130, Canton, TX 75103 | 2018-02-19 |
| 1396292918 | Deanne Wheeler | Hearing Instrument Specialist | 150 E. Dallas Street, Canton, TX 75103 | 2016-09-01 |
| 1356701221 | Betsy Jill Chappell | Nurse Practitioner | 406 Tx-243, Canton, TX 75103 | 2016-03-04 |
| 1326435199 | Forever Kids Pediatric Clinic | Clinic/Center | 182 Privatet Road 6413, Canton, TX 75103 | 2015-04-20 |
| 1417255233 | Dallas County Hospital District | Skilled Nursing Facility | 1901 S Trade Days Blvd, Canton, TX 75103 | 2011-03-02 |
| 1922243906 | Brookshire Grocery Company | Pharmacy | 880 E State Highway 243, Canton, TX 75103 | 2008-12-05 |
| Find all providers in zip 75103 | ||||
| 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 |
|---|---|---|---|---|
| 1871100412 | Forever Harmony PCh Inc | Assisted Living Facility | 205 Providence Walk Ct, Canton, GA 30114-8622 | 2020-09-28 |
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1578118451 | Embrace Group Home LLC | Assisted Living Facility | 6934 N Canton Center Rd, Canton, MI 48187-1647 | 2019-08-07 |
| 1174093199 | Stone Crossing Skilled Care, LLC | Assisted Living Facility | 836 34th Street, Nw, Canton, OH 44709 | 2018-12-03 |
| 1831626266 | Stone Crossing Assisted Living, LLC | Assisted Living Facility | 820 34th St Nw, Canton, OH 44709-2966 | 2017-05-16 |
| 1922533736 | C&y Homes, Inc. | Assisted Living Facility | 3616 Rolling Ridge Rd Ne, Canton, OH 44721-3029 | 2017-04-30 |
| 1447662234 | Cornerstone At Canton Assisted Living LLC | Assisted Living Facility | 175 Revere Street, Canton, MA 02021 | 2014-05-28 |
| 1689901563 | Brookdale Senior Living Communities Inc | Assisted Living Facility | 1119 Perry Dr Nw, Canton, OH 44708-3374 | 2009-11-12 |
| 1164689766 | Ann Davis Rest Home | Assisted Living Facility | 460 Beaverdam St, Canton, NC 28716 | 2008-05-21 |
| 1932383973 | Petersen Health Care, Inc. | Assisted Living Facility | 160 East Walnut Street, Canton, IL 61520-2708 | 2007-12-27 |
| Find all providers in CANTON | ||||
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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.