LEGACY LIVING CENTERS - NPI 1447246145 - Nursing Facility/Intermediate Care Facility in Kilgore, TX

Q: What is Kilgore Manor Inc's NPI number?

The NPI number for Kilgore Manor Inc is 1447246145. It was assigned to this organization in the NPPES registry on September 27, 2005. The provider is doing business as Legacy Living Centers.

Q: What is Kilgore Manor Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Q: When was this NPI record last updated?

The NPPES record for Kilgore Manor Inc was last updated on August 28, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Legacy Living Centers NPPES

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

LEGACY LIVING CENTERS (NPI 1447246145) is a healthcare organization registered as a nursing facility/intermediate care facility in Kilgore, Texas and active in the NPI registry since September 2005. The organization lists Janice Pita, Insurance/medicare, as its authorized official.

NPPES Registry Identity

NPI1447246145

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameKILGORE MANOR INC

Location Address2700 S HENDERSON BLVDKilgore, TX 75662-4033

Mailing Address2700 S Henderson BlvdKilgore, TX 75662-4033 · (903) 984-3511 · Fax (903) 983-1031

Phone(903) 984-3511

Fax(903) 983-1031

Organization SubpartNo

Authorized OfficialJanice PitaInsurance/medicare · (580) 622-6300

Enumeration DateSeptember 27, 2005

Last NPPES UpdateAugust 28, 2008

✔ NPI 1447246145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

License✔ Licensed in TX · 112798

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

2700 S HENDERSON BLVD, Kilgore, TX 75662

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Other Names 1

Doing Business AsLegacy Living Centers

Other Identifiers 4

Other0220162-01TX · Texas Medicaid B

Medicare ID-Type Unspecified67-5814TX · Medicare Texas

OtherHH2539TX · Blue Cross Blue Shield

Medicaid00102185TX

Other Providers at the Same Location NPPES 7

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

CURTIS EVANS PTA

Physical Therapy Assistant