DEVELOPMENTAL DISABILITIES MANAGEMENT SERVICES OF BEAUMONT, LLC (NPI# 1629475520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629475520 |
| Entity Type | Organization |
| Organization Name | DEVELOPMENTAL DISABILITIES MANAGEMENT SERVICES OF BEAUMONT, LLC |
| Practice Address |
411 5th Ave Port Arthur TX 77642-3389 |
| 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 |
| 1558768457 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4415 Jerry Dr, Beaumont, TX 77703-1923 | 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 |
| Street Address |
411 5TH AVE |
| City | PORT ARTHUR |
| State | TX |
| Zip Code | 77642-3389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013132331 | Golden Triangle Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 411 5th Ave, Port Arthur, TX 77642-3389 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038253 | Residential Senior Care (rsc) | Assisted Living Facility | 8040 Honeywood Trial, Port Arthur, TX 77642 | 2020-09-23 |
| 1912547746 | Port Arthur Surgical Center, LLC | Clinic/Center | 3919 Twin City Hwy, Port Arthur, TX 77642 | 2020-01-09 |
| 1538533906 | Carolyn Williams | Nurse Practitioner | 8333 9th Ave Ste A, Port Arthur, TX 77642 | 2015-11-22 |
| 1003295312 | Peacock Heavenly Massage | Massage Therapist | 3800 Hwy 365, Regional Square, Port Arthur, TX 77642 | 2015-05-20 |
| 1346651718 | Bunrith Koy | Family Medicine | 3620 East Farm To Market Road 365, Port Arthur, TX 77642 | 2014-05-19 |
| 1679896534 | Jared Clark Mallory | Physical Therapist | 3398 25th Street, Port Arthur, TX 77642 | 2010-03-08 |
| 1750564902 | Isam N. Anabtawi | Family Medicine | 1750 9th Ave., Suite 202, Port Arthur, TX 77642 | 2007-12-11 |
| 1710179445 | Marian Tan Medical Group Ltd LLP | Pediatrics | 3220 Central Mall Drive, Port Arthur, TX 77642 | 2007-08-16 |
| 1497952253 | Waheeda Mithani | Surgery | 3820 Hwy. 365, Suite 200, Port Arthur, TX 77642 | 2007-06-27 |
| 1295939015 | Pamela Spencer Albacete | Speech-Language Pathologist | 7200 9th Ave., Port Arthur, TX 77642 | 2007-06-14 |
| Find all providers in zip 77642 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1093112997 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3905 28th St, Port Arthur, TX 77642-3923 | 2014-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581782 | Joyful Psalm | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1354 Ravenwood Ct, Crowley, TX 76036-3472 | 2020-09-04 |
| 1790394161 | Modern Vintage Residential Care, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4015 Alexis Tate Cir, Missouri City, TX 77459-5039 | 2020-07-30 |
| 1285253856 | 1 Care Premier Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 340 N Sam Houston Pkwy E Ste A247, Houston, TX 77060-3305 | 2020-04-13 |
| 1568093888 | James Micah Howard | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11911 Lakewood Trl, Tomball, TX 77377-8563 | 2020-01-27 |
| 1518507110 | Gems Residence LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5810 Liverpool St, Aubrey, TX 76227-1909 | 2020-01-10 |
| 1366081812 | Abundant Care Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Maxfield St, Waco, TX 76705-2967 | 2020-01-02 |
| 1306487426 | Fort Healthcare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5833 Oakbend Trail, #200, Fort Worth, TX 76132-3900 | 2019-09-30 |
| 1144877481 | Boniswa Portia Maduna | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8000 Cook Rd Apt 1109, Houston, TX 77072-3939 | 2019-08-21 |
| 1871148171 | Kenneth Allen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 135 E Menefee St, Lufkin, TX 75901-4701 | 2019-08-05 |
| 1124673553 | 1st A & M Healthcare Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 504 Spicewood Dr, Desoto, TX 75115-1485 | 2019-08-02 |
| Find all providers with the same taxonomy | ||||
| City | PORT ARTHUR |
| Zip Code | 77642 |
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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.