LEGACY LIVING CENTERS (NPI# 1598752495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598752495 |
| Entity Type | Organization |
| Organization Name | LEGACY LIVING CENTERS |
| Other Organization Name | FORT WORTH MANOR |
| Practice Address |
4900 E Berry St Fort Worth TX 76105-4314 |
| Practice Telephone | 8175313707 |
| Practice Fax Number | 8175361648 |
| Mailing Telephone | 8175313707 |
| Mailing Fax Number | 8175361648 |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MARIE LAWSON (ADMINISTRATOR) |
| Authorized Official Telephone | 8175313707 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 113559 | TX | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Fort Worth Manor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912995689 | Legacy Living Centers | Nursing Facility/Intermediate Care Facility | 700 Palm Dr, Duncan, OK 73533-3324 | 2005-10-07 |
| Street Address |
4900 E BERRY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76105-4314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518418128 | Robert Marriott Medical Corp | Surgery | 4900 E Berry St, Fort Worth, TX 76105-4314 | 2016-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477030567 | Brandon Ronald Lee | Optometrist | 2644 E Berry St., Fort Worth, TX 76105 | 2018-07-23 |
| 1366935165 | National Vision, Inc. | Technician/Technologist | 2644 East Berry Street, Fort Worth, TX 76105 | 2018-06-07 |
| 1609363100 | Courtney Mae Gramley | Specialist/Technologist | 1201 Wesleyan St., Fort Worth, TX 76105 | 2018-04-19 |
| 1992213078 | Fresenius Medical Care Se Fort Worth, LLC | Clinic/Center | 3708 E Rosedale St, Fort Worth, TX 76105 | 2018-01-11 |
| 1285978692 | Wal-mart Stores Texas LLC | Technician/Technologist | 2900 Renaissance Square, Fort Worth, TX 76105 | 2012-11-26 |
| 1548584998 | Access Dental of Berry, P.a. | Dentist | 4201 E. Berry Street, Suite #15, Fort Worth, TX 76105 | 2010-03-15 |
| 1811211261 | Access Dental of Rosedale P.a. | Dentist | 3620 E. Rosedale Street, Fort Worth, TX 76105 | 2010-03-15 |
| 1396345799 | Danielle Hampton | Pharmacist | Walmart Pharmacy, 2900 Renaissance Square, Fort Worth, TX 76105 | 2020-10-27 |
| 1174041578 | Destonee Wilson | Physician Assistant | 1650 S Beach St, Fort Worth, TX 76105 | 2017-09-06 |
| 1184019929 | Sheelarani Joseph | Nurse Practitioner | 1650 S Beach St, Fort Worth, TX 76105 | 2015-03-30 |
| Find all providers in zip 76105 | ||||
| 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 | 76105 |
Please comment or provide details below to improve the information on LEGACY LIVING CENTERS.
| 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.