1. Home
  2. Directory
  3. Texas
  4. Beaumont
  5. Assisted Living Facility
  6. NPI Profile

PELICAN BAY
NPI 1861767832
Assisted Living Facility in Beaumont, TX

Active since March 09, 2012CLIA 45D2205329 · Waiver
2501 S MAJOR DR, BEAUMONT, TX 77707(409) 860-3500(409) 962-9253 Get Directions Write a Review

NPPES record last updated: June 20, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pelican Bay NPPES

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

PELICAN BAY (NPI 1861767832) is a healthcare organization registered as an assisted living facility in Beaumont, Texas and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through December 13, 2026 and lists James W. Moore, President, as its authorized official.

NPPES Registry Identity

NPI1861767832
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePELICAN ASSISTED LIVING LLC
Location Address2501 S MAJOR DRBeaumont, TX 77707-5018
Mailing Address4500 Main AveGroves, TX 77619-4712 · (409) 962-4450 · Fax (409) 962-9253
Phone(409) 860-3500
Fax(409) 962-9253
Organization SubpartNo
Authorized OfficialJames W. MoorePresident · (409) 962-4450
Enumeration DateMarch 9, 2012
Last NPPES UpdateJune 20, 2018
✔ NPI 1861767832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
2501 S MAJOR DR, Beaumont, TX 77707
Open in Google Maps ↗

Other Names 1

Doing Business AsPelican Bay

Other Identifiers 1

Other32044376872TX · Texas Comptroller Of Public Accounts Taxpayer Number

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 45D2205329

Pelican Bay Of Beaumont · Beaumont, TX
Active · expires Dec 13, 2026
CLIA Number45D2205329
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 14, 2024
Certificate Expiration DateDecember 13, 2026
Laboratory DirectorChristina L. Trentham
Laboratory Phone(409) 860-3500
Laboratory LocationPelican Bay Of Beaumont2501 South Major Drive, Beaumont, TX 77707
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

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

SHELLEY M SMITH OT
Occupational Therapist
2501 S MAJOR DR
BEAUMONT, TX 77707
Jefferson County (409) 234-6065

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 Pelican Assisted Living LLC's NPI number?

The NPI number for Pelican Assisted Living LLC is 1861767832. It was assigned to this organization in the NPPES registry on March 9, 2012. The provider is doing business as Pelican Bay.

Where is Pelican Assisted Living LLC located?

Pelican Assisted Living LLC is located at 2501 S Major Dr, Beaumont, TX 77707. The listed phone number is (409) 860-3500.

What is Pelican Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Pelican Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2205329) is associated with this NPI, valid through December 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pelican Assisted Living LLC was last updated on June 20, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.