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GOLDEN TRIANGLE LIVING CENTERS INC. NPI 1720203045


NPI Information

NPI: 1720203045
Provider Name: GOLDEN TRIANGLE LIVING CENTERS, INC.

Doing Business As: MCANNELLY COMMUNITY HOME

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
5125 MCANELLY DR
BEAUMONT, TX
ZIP 77708
Phone: (409) 832-4112
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GOLDEN TRIANGLE LIVING CENTERS, INC. is an intermediate care facility mentally retarded in Beaumont, TX. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. GOLDEN TRIANGLE LIVING CENTERS, INC. NPI is 1720203045. The provider is registered as an organization entity type.
The provider Is Doing Business As Mcannelly Community Home.

The provider's business location address is:

5125 MCANELLY DR
BEAUMONT, TX
ZIP 77708-901
Phone: (409) 832-4112

The provider's authorized official is James E. Richardson .
The authorized official title is C.e.o. and has the following contact phone number (318) 445-6470.

The enumeration date for this NPI number is 4/13/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10040140145MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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