DEVELOPMENTAL DISABILITIES MANAGEMENT SERVICES OF BEAUMONT, LLC (NPI# 1558768457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558768457 |
| Entity Type | Organization |
| Organization Name | DEVELOPMENTAL DISABILITIES MANAGEMENT SERVICES OF BEAUMONT, LLC |
| Practice Address |
4415 Jerry Dr Beaumont TX 77703-1923 |
| Mailing Address |
2750 S 4th St Beaumont TX 77701-7912 |
| Practice Telephone | 4098324112 |
| Mailing Telephone | 4098324112 |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |
| Authorized Official Name | WAYNE ADDISON (COO) |
| Authorized Official Telephone | 9016925555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | TX | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | APPLIED FOR | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912304544 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9640 Meadowick Dr, Beaumont, TX 77706-3859 | 2014-11-25 |
| 1285031187 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2810 Sheridan Ln, Port Arthur, TX 77640-2644 | 2014-11-21 |
| 1083011985 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 101 Oglesbee Rd, Silsbee, TX 77656-5925 | 2014-11-21 |
| 1720485626 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5010 Ada St, Beaumont, TX 77708-4411 | 2014-11-21 |
| 1912304817 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1309 Nottingham Dr, Orange, TX 77632-0449 | 2014-11-21 |
| 1821495722 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1924 Thousand Oaks Dr, Orange, TX 77632-1215 | 2014-11-21 |
| 1285031179 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1760 Sams Way, Beaumont, TX 77706-3128 | 2014-11-21 |
| 1376940262 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10980 Pine Haven St, Beaumont, TX 77713-8700 | 2014-11-21 |
| 1194122093 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11510 Loop Rd, Beaumont, TX 77713-8664 | 2014-11-21 |
| 1467859355 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5125 Mcanelly Dr, Beaumont, TX 77708-1901 | 2014-11-21 |
| Street Address |
4415 JERRY DR |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77703-1923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407071723 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 4415 Jerry Dr, Beaumont, TX 77703-1923 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548687684 | Christie N Beaugh | Counselor | 2574 North 11th Street, Beaumont, TX 77703 | 2014-03-26 |
| 1366728040 | Beaumont Orthodontic Specialists | Dentist | 3954 Eastex Freeway, Beaumont, TX 77703 | 2011-10-26 |
| 1033395660 | Danari, Inc | Durable Medical Equipment & Medical Supplies | 2190 Eastex Freeway, Beaumont, TX 77703 | 2008-01-14 |
| 1801091848 | Catholic Charities of Southeast Texas | Counselor | 2780 Eastex Freeway, Beaumont, TX 77703 | 2007-06-19 |
| 1487874400 | Joseph W Provo IIi | Dentist | 1460 Ih 10 East, Suite A, Beaumont, TX 77703 | 2007-05-01 |
| 1023134608 | Assisted Living Concepts Inc | Assisted Living Facility | 2910 Toccoa Road, Beaumont, TX 77703 | 2007-03-22 |
| 1134233059 | Golden Traingle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 4415 Jerry, Beaumont, TX 77703 | 2006-08-18 |
| 1225142144 | Golden Triangle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 6270 Carnation Dr, Beaumont, TX 77703 | 2006-08-18 |
| 1760588123 | Patrick Joseph Concannon | Radiologic Technologist | 2002 Holcombe Blvd, Houston, TX 77703 | 2006-09-15 |
| 1487214987 | Edalynn Roper | Home Health Aide | 4885 Detroit St, Beaumont, TX 77703-1416 | 2019-06-17 |
| Find all providers in zip 77703 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285098764 | Initiative Care Group Hcs | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 730 Adams St, Beaumont, TX 77705-4126 | 2016-04-11 |
| 1063616548 | Golden Triangle Living Center, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2750 S 4th St, Beaumont, TX 77701-7912 | 2007-06-11 |
| 1912304544 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9640 Meadowick Dr, Beaumont, TX 77706-3859 | 2014-11-25 |
| 1720485626 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5010 Ada St, Beaumont, TX 77708-4411 | 2014-11-21 |
| 1285031179 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1760 Sams Way, Beaumont, TX 77706-3128 | 2014-11-21 |
| 1376940262 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10980 Pine Haven St, Beaumont, TX 77713-8700 | 2014-11-21 |
| 1194122093 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11510 Loop Rd, Beaumont, TX 77713-8664 | 2014-11-21 |
| 1467859355 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5125 Mcanelly Dr, Beaumont, TX 77708-1901 | 2014-11-21 |
| 1720485683 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3895 Cheryl St, Beaumont, TX 77713-9547 | 2014-11-20 |
| 1134525413 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6270 Carnation Dr, Beaumont, TX 77706-5505 | 2014-11-13 |
| 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.