MANSFIELD LONG TERM CARE LLC (NPI# 1710378575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710378575 |
| Entity Type | Organization |
| Organization Name | MANSFIELD LONG TERM CARE LLC |
| Other Organization Name | THE PAVILION AT CREEKWOOD |
| Practice Address |
2100 Cannon Drive Mansfield TX 76063 |
| Mailing Address |
920 Ridgebrook Rd Sparks MD 21152-9390 |
| Practice Telephone | 8177796500 |
| Practice Fax Number | 8177796501 |
| Mailing Telephone | 8177796500 |
| Mailing Fax Number | 8177796501 |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2019-10-17 |
| Authorized Official Name | SUZANNE MEYER (PRESIDENT) |
| Authorized Official Telephone | 8177796500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 001026926 | 05 |
| Other Name | Type Code |
|---|---|
| The Pavilion at Creekwood | Doing Business As Name - Organization |
| Street Address |
2100 CANNON DRIVE |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| 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 |
|---|---|---|---|---|
| 1922309962 | Mansfield Snf LLC | Skilled Nursing Facility | 200 E. Debbie Lane, Mansfield, TX 76063 | 2010-11-08 |
| 1720123318 | Crystal Care Center of Mansfield Inc. | Skilled Nursing Facility | 1159 Wyandotte Ave., Mansfield, OH 44906-1940 | 2007-02-21 |
| 1073687752 | Healthcare Ventures of Ohio LLC | Skilled Nursing Facility | 1670 Crider Rd, Mansfield, OH 44903-9268 | 2006-11-17 |
| 1124199849 | Northern Health Facilities, Inc. | Skilled Nursing Facility | 1600 Crider Rd, Mansfield, OH 44903-9268 | 2006-11-13 |
| 1942308861 | J-s Mansfield Operations, Lp | Skilled Nursing Facility | 301 N Miller Rd, Mansfield, TX 76063 | 2006-09-21 |
| 1538182654 | N & R of Mansfield, LLC | Skilled Nursing Facility | 3111 Highway A, Mansfield, MO 65704-8105 | 2006-07-26 |
| 1821018649 | Mansfield Memorial Homes, Inc | Skilled Nursing Facility | 50 Blymyer Ave, Mansfield, OH 44903-2343 | 2006-07-21 |
| 1174506075 | Levering Management, Inc. | Skilled Nursing Facility | 70 Winchester Rd, Mansfield, OH 44907-2042 | 2005-11-23 |
| 1396728739 | Desoto Retirement & Rehab Center, LLC | Skilled Nursing Facility | 635 Schley St, Mansfield, LA 71052-3820 | 2005-11-21 |
| 1346223708 | Mansfield Nursing Center, L.L.C. | Skilled Nursing Facility | 1725 Mcarthur Dr, Mansfield, LA 71052-4501 | 2005-11-21 |
| Find all providers in MANSFIELD | ||||
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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.