SHADY SHORES OF PREMONT LLC (NPI# 1881079101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881079101 |
| Entity Type | Organization |
| Organization Name | SHADY SHORES OF PREMONT LLC |
| Other Organization Name | PREMONT REHAB AND NURSING CENTER |
| Practice Address |
431 Nw 3rd St. Premont TX 78375 |
| Mailing Address |
320 Eagle Dr Suite 201 Denton TX 76201-6898 |
| Practice Telephone | 3613483553 |
| Mailing Telephone | 9402281414 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2016-06-14 |
| Authorized Official Name | MICHAEL WALLACE (CEO) |
| Authorized Official Telephone | 2144221622 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Premont Rehab and Nursing Center | Doing Business As Name - Organization |
| Street Address |
431 NW 3RD ST. |
| City | PREMONT |
| State | TX |
| Zip Code | 78375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366492266 | Victor Amaro | Contractor | 344 S. W. 4th, Premont, TX 78375 | 2006-05-11 |
| 1366402430 | Premont Nursing Home, Inc. | Nursing Facility/Intermediate Care Facility | 431 N.w. 3rd Street, Premont, TX 78375 | 2006-03-24 |
| 1306334016 | Pre Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 431 N.w. 3rd Street, Premont, TX 78375 | 2018-04-27 |
| 1386047181 | Premont Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 431 N.w. 3rd Street, Premont, TX 78375 | 2014-10-07 |
| 1124290150 | Premont Rehab and Nursing Center, Inc | Skilled Nursing Facility | 431 Nw 3rd Street, Premont, TX 78375-0260 | 2008-03-31 |
| 1194253674 | Olivia Schacherl | Technician | Po Box 306, Premont, TX 78375-0306 | 2017-05-30 |
| 1770028565 | In Home Provider Services | Technician | 515 S. Broadway St., Premont, TX 78375-0306 | 2017-01-03 |
| 1497973390 | Premont Isd | Local Education Agency (LEA) | 439 Sw 4th Street, Premont, TX 78375-0530 | 2007-04-23 |
| 1699035105 | Sherri Hines | Counselor | 304 Sw 10th St., Premont, TX 78375-0887 | 2012-05-18 |
| 1972680734 | La Paloma Ems | Ambulance | 145 Nw First St, Premont, TX 78375-1290 | 2006-11-01 |
| Find all providers in zip 78375 | ||||
| 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 |
|---|---|---|---|---|
| 1124290150 | Premont Rehab and Nursing Center, Inc | Skilled Nursing Facility | 431 Nw 3rd Street, Premont, TX 78375-0260 | 2008-03-31 |
| 1306334016 | Pre Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 431 N.w. 3rd Street, Premont, TX 78375 | 2018-04-27 |
| 1386047181 | Premont Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 431 N.w. 3rd Street, Premont, TX 78375 | 2014-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233171 | Center At Zaragoza, LLC | Skilled Nursing Facility | 12660 Pebble Hills Blvd., El Paso, TX 79936 | 2020-10-21 |
| 1609473362 | Touchstone Strategies - Penitas, LLC | Skilled Nursing Facility | 414 Liberty Blvd., Penitas, TX 78576 | 2020-10-06 |
| 1649884313 | Springtown Ventures Lp | Skilled Nursing Facility | 201 Williams Ward Rd., Springtown, TX 76082 | 2020-09-01 |
| 1821601691 | Altamira Healthcare LLC | Skilled Nursing Facility | 200 Carla St, Zapata, TX 78076-3114 | 2020-08-31 |
| 1538770839 | Go Operations 3 LLC | Skilled Nursing Facility | 4366 Lockhill Selma, Shavano, TX 78249 | 2020-08-11 |
| 1912516329 | Patriot Skilled Nursing and Rehabilitation LLC | Skilled Nursing Facility | 11490 Gateway N Blvd., El Paso, TX 79934 | 2020-07-31 |
| 1972112464 | The Brixton At Horseshoe Bay | Skilled Nursing Facility | 15101 West Fm 2147, Horseshoe Bay, TX 78657 | 2020-07-30 |
| 1558984278 | Slp Johnson City LLC | Skilled Nursing Facility | 206 Haley Rd, Johnson City, TX 78636-4617 | 2020-05-28 |
| 1073136149 | Continuum Rehab Group | Skilled Nursing Facility | 3326 Burgoyne St # 1432, Dallas, TX 75233-1304 | 2020-05-24 |
| 1750904264 | Frank Villanueva | Skilled Nursing Facility | 711 W Broadway St, Denver City, TX 79323-3000 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHADY SHORES OF PREMONT LLC.
| 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.