GOLDEN TRIANGLE LIVING CENTER, INC (NPI# 1780908103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780908103 |
| Entity Type | Organization |
| Organization Name | GOLDEN TRIANGLE LIVING CENTER, INC |
| Other Organization Name | ROOSEVELT COMMUNITY HOME |
| Practice Address |
1020 Roosevelt Dr Silsbee TX 77656-3408 |
| Mailing Address |
2750 S 4th St Beaumont TX 77701-7912 |
| Practice Telephone | 4093853723 |
| Mailing Telephone | 4098324112 |
| Mailing Fax Number | 3186413717 |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2010-03-15 |
| Authorized Official Name | MR. JAMES E RICHARDSON (CEO) |
| Authorized Official Telephone | 3184456470 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 0000I8H4S | 05 |
| Other Name | Type Code |
|---|---|
| Roosevelt Community Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205150620 | Golden Triangle Living Center, Inc | Intermediate Care Facility, Mentally Retarded | 2204 24th St, Orange, TX 77630-3115 | 2010-03-15 |
| 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 |
| Street Address |
1020 ROOSEVELT DR |
| City | SILSBEE |
| State | TX |
| Zip Code | 77656-3408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922143700 | East Texas Community Services for The Developmentally Disabled, Inc. | Intermediate Care Facility, Mentally Retarded | 1020 Roosevelt Dr, Silsbee, TX 77656-3408 | 2007-02-20 |
| 1538566435 | Developmental Disabilities Management Services of Beaumont, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1020 Roosevelt Dr, Silsbee, TX 77656-3408 | 2014-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164822813 | John Simmons | Nurse Practitioner | 280 Farm Rd 418, Silsbee, TX 77656 | 2014-08-31 |
| 1740572460 | Sam'marie Smith | Physical Therapy Assistant | 705 Highway 418 W, Silsbee, TX 77656 | 2011-05-13 |
| 1194054338 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 496 Highway 96 S, Silsbee, TX 77656 | 2009-12-17 |
| 1740456474 | Natalie J Peveto P. C. | Chiropractor | 3674 Highway 96 North, Silsbee, TX 77656 | 2008-05-02 |
| 1003001918 | Karen Kay Goad | Physical Therapist | 1162 Hwy 327 East, Silsbee, TX 77656 | 2007-09-13 |
| 1043331101 | Oakbend Medical Center | Skilled Nursing Facility | 705 Fm 418 West, Silsbee, TX 77656 | 2007-04-03 |
| 1457458952 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 685 Hwy 96 S, Silsbee, TX 77656 | 2006-09-20 |
| 1427060128 | James Richard Landis | Dentist | 1164 Hwy 327 E, Silsbee, TX 77656 | 2006-08-12 |
| 1790799369 | Jerri K Frazier | Physical Therapist | 1162 Hwy 327 E, Silsbee, TX 77656 | 2006-07-28 |
| 1689601841 | Ghaleb S Al Awar | Family Medicine | 1185 N 11th St, Silsbee, TX 77656 | 2006-06-26 |
| Find all providers in zip 77656 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477698488 | East Texas Community Services for The Developmentally Disabled, Inc. | Intermediate Care Facility, Mentally Retarded | 101 Oglesbee Rd, Silsbee, TX 77656-5925 | 2007-02-20 |
| 1922143700 | East Texas Community Services for The Developmentally Disabled, Inc. | Intermediate Care Facility, Mentally Retarded | 1020 Roosevelt Dr, Silsbee, TX 77656-3408 | 2007-02-20 |
| 1740504984 | Golden Triangle Living Center | Intermediate Care Facility, Mentally Retarded | 101 Oglesbee Rd, Silsbee, TX 77656-5925 | 2010-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639271 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3323 Gail Ln, Tyler, TX 75701-7425 | 2020-11-05 |
| 1952902900 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2500 Terry Pl, Greenville, TX 75402-7131 | 2020-11-05 |
| 1811598865 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 100 Patti J St, Greenville, TX 75402-8053 | 2020-11-05 |
| 1124629175 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2616 Pounds Ave, Tyler, TX 75701-5627 | 2020-11-05 |
| 1568063527 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2525 Preston Ave, Tyler, TX 75701-4644 | 2020-11-05 |
| 1104427509 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2812 Shaffer Ln, Tyler, TX 75702-1653 | 2020-11-03 |
| 1265033658 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3506 Garber Cir, Greenville, TX 75402-6234 | 2020-11-03 |
| 1487255873 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3600 New Copeland Rd, Tyler, TX 75701-8839 | 2020-11-03 |
| 1306446000 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 6520 Braddock Pl, Dallas, TX 75232-2902 | 2020-10-30 |
| 1578179750 | Keondra C Johnson | Intermediate Care Facility, Mentally Retarded | 2140 Medical District Dr Apt 2052, Dallas, TX 75235-8097 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
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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.