CARRIAGE INN-LAKE JACKSON
NPI 1285985929
Assisted Living Facility in Friendswood, TX
- Organization
- Assisted Living Facility
- CLIA Number: 45D2064408
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 07-21-2026
About CARRIAGE INN-LAKE JACKSON
This page provides the complete NPI Profile along with additional information for Carriage Inn-lake Jackson, a provider established in Friendswood, Texas operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1285985929 assigned on September 2012. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Carriage Inn-lake Jackson. The authorized official of this NPI record is Mr. James D. Gray (Manager)
- NPI
- 1285985929 Verify this NPI
- Provider Legal Name
- BRIDGEWOOD LAKE JACKSON, LLC
- Other Organization Name
- CARRIAGE INN-LAKE JACKSON
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 211 E PARKWOOD AVE STE 100 FRIENDSWOOD, TX 77546
- Location Phone
- (281) 996-0101
- Location Fax
- (281) 996-1141
- Mailing Address
- 130 LAKE RD LAKE JACKSON, TX 77566
- Mailing Phone
- (979) 285-0300
- Mailing Fax
- (979) 285-0338
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-20-2012
- Last Update Date
- 09-20-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Assisted Living Facility
- Taxonomy Code
- 310400000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2064408
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- July 22, 2024
- Certificate Expiration Date
- July 21, 2026
- Laboratory Director
- SHELLIE MILLER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Carriage Inn-lake Jackson to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
FRIENDSWOOD, TX 77546
FRIENDSWOOD, TX 77546
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285985929, enumerated as an "organization" on September 20, 2012.
The provider is located at 211 E PARKWOOD AVE STE 100 FRIENDSWOOD, TX 77546 and the phone number is (281) 996-0101.
Assisted Living Facility with taxonomy code 310400000X.
