CINDY JOHNSON KENDRASHA GRAY


Address: 801 S Mobberly Ave, Longview, TX 75602-2037
Phone: 9034248343

CINDY JOHNSON KENDRASHA GRAY (NPI# 1720590870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720590870
Entity Type Organization
Organization Name CINDY JOHNSON KENDRASHA GRAY
Practice Address 801 S Mobberly Ave
Longview
TX 75602-2037
Mailing Address 314 S 9th St
Longview
TX 75602-1303
Practice Telephone 9034248343
Practice Fax Number 9034248343
Mailing Telephone 9034248343
Enumeration Date 2017-10-30
Last Update Date 2019-09-25
Authorized Official Name CINDY ROLLINS (GENERAL PARTNER)
Authorized Official Telephone 9034248343
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Office Location

Street Address 801 S MOBBERLY AVE
City LONGVIEW
State TX
Zip Code 75602-2037

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598275364 Cindy N Rollins Case Manager/Care Coordinator 801 S Mobberly Ave, Longview, TX 75602-2037 2017-10-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083150569 Mcet-longview Clinic/Center 505 North Sixth Street, Longview, TX 75602 2017-01-09
1962561597 Robert Lee Harper Dentist 1002 So M L King Jr Blvd, Longview, TX 75602 2006-12-08
1033202700 Hervey & Bethard Inc. Durable Medical Equipment & Medical Supplies 1900 S. High St., Longview, TX 75602 2006-10-02
1023426665 Longview Wellness Center, Inc Clinic/Center 2131 S Mobberly Ave, Longview, TX 75602 2014-07-28
1063748796 Jeffery Michael Stowers Pharmacist 1900 S High St, Longview, TX 75602 2009-10-31
1326541368 Tonie Elaine Bryant Licensed Vocational Nurse 1006 Flanagan Dr, Longview, TX 75602-1013 2018-03-15
1285145839 Maria Tran Specialist/Technologist 16 Covington Dr, Longview, TX 75602-1071 2017-10-21
1639635444 G and T Young At Heart Counselor 1012 E Cotton St, Longview, TX 75602-1322 2019-02-17
1982020038 Julie A Dollison Perfusionist 301 S Club Dr, Longview, TX 75602-1511 2014-03-13
1881009231 Brandi Mccracken Specialist/Technologist, Other 301 S Club Dr, Longview, TX 75602-1511 2014-06-24
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487097168 Adept Care Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1723 Loring Ln, Longview, TX 75604-4426 2013-04-11
1871879775 Amazing Living Hcs, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2206 Jahan Trl, Longview, TX 75604-2521 2011-10-24
1053695403 Precious Hand's Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 209 Hailey Dr, Longview, TX 75602-2803 2011-10-04
1457583072 S & S Residential LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 409a S Main St, Longview, TX 75601-7432 2009-08-15
1669675278 Brannon's Friends LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 407 E Pirate St, Longview, TX 75604-2427 2007-06-10
1689890592 Janice M. Leonard Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 408 Fawn Trl # A, Longview, TX 75604-1911 2007-04-18
1356695480 Shacklefree Ministries Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 409 N Fredonia St, Suite 116, Longview, TX 75601-6466 2012-10-26
1619171840 Harmony Living Centers Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 112 S Ward Dr, Longview, TX 75604-5052 2007-06-12
1750491791 Sheila Isaac Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 409 S Main St, Suite A, Longview, TX 75601-7432 2006-08-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1750980686 Mimshack Care Homes LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 12330 Springcrest Dr, Houston, TX 77072-3219 2020-10-21
1679172936 Re-care Incorporated Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 200 University Blvd Ste 225-374, Round Rock, TX 78665-1001 2020-10-19
1407454176 Viandsa Care Home LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 17203 Quiet Song Ct, Richmond, TX 77407-2964 2020-10-14
1053919050 Building Bridges In Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2007 Liberty Cove Ct, Richmond, TX 77469-2338 2020-10-12
1497353635 Helping Hearts Residential Care, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 20319 Bridge Manor Ln, Richmond, TX 77407-6494 2020-10-10
1750989067 Able Wisdom Services Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2203 Huntington Dr, Wylie, TX 75098-7164 2020-10-09
1518573609 Jbk House of Care LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2624 Grand Gulf Rd, Fort Worth, TX 76123-2613 2020-09-23
1700492352 St Monica Healthcare Services Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 11311 Scottsdale Dr, Meadows Place, TX 77477-1811 2020-09-18
1265047534 Compassion Structured Living Center LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 13578 San Martin Ln, Houston, TX 77083-5135 2020-09-13
1497369474 Nexphase Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1201 N Watson Rd Ste 205, Arlington, TX 76006-6120 2020-09-07
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Competitor

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City LONGVIEW
Zip Code 75602

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Dataset Information

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.

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