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JERRY LIVING CENTER
NPI 1407071723
Intermediate Care Facility, Intellectual Disabilities in Beaumont, TX

Active since April 13, 2007CLIA 45D2111703 · Waiver
4415 JERRY DR, BEAUMONT, TX 77703(409) 832-4112 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry Living Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY LIVING CENTER (NPI 1407071723) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Beaumont, Texas and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through April 12, 2028 and lists James E. Richardson, C.e.o., as its authorized official.

NPPES Registry Identity

NPI1407071723
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameGOLDEN TRIANGLE LIVING CENTERS, INC.
Location Address4415 JERRY DRBeaumont, TX 77703-1923
Mailing Address715 Main StPineville, LA 71360-6937
Phone(409) 832-4112
Organization SubpartNo
Authorized OfficialJames E. RichardsonC.e.o. · (318) 445-6470
Enumeration DateApril 13, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1407071723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
4415 JERRY DR, Beaumont, TX 77703
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Other Names 1

Doing Business AsJerry Living Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2111703

Jerry Living Center · Beaumont, TX
Active · expires Apr 12, 2028
CLIA Number45D2111703
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateApril 13, 2026
Certificate Expiration DateApril 12, 2028
Laboratory DirectorLawtrice D. Budwine
Laboratory Phone(409) 832-4112
Laboratory LocationJerry Living Center4415 Jerry Drive, Beaumont, TX 77703
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEVELOPMENTAL DISABILITIES MANAGEMENT SERVICES OF BEAUMONT, LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
4415 JERRY DR
BEAUMONT, TX 77703
Jefferson County (409) 832-4112
DUNGARVIN TEXAS, LLC
Intermediate Care Facility, Intellectual Disabilities
4415 JERRY DR
BEAUMONT, TX 77703
Jefferson County (409) 899-4766

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Golden Triangle Living Centers, Inc.'s NPI number?

The NPI number for Golden Triangle Living Centers, Inc. is 1407071723. It was assigned to this organization in the NPPES registry on April 13, 2007. The provider is doing business as Jerry Living Center.

Where is Golden Triangle Living Centers, Inc. located?

Golden Triangle Living Centers, Inc. is located at 4415 Jerry Dr, Beaumont, TX 77703. The listed phone number is (409) 832-4112.

What is Golden Triangle Living Centers, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Golden Triangle Living Centers, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2111703) is associated with this NPI, valid through April 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Golden Triangle Living Centers, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.