NICOLE JEFFERSON NPI 1174023063

NPI Information

NPI: 1174023063
Provider Name: NICOLE JEFFERSON
Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
Entity Type: Individual
Address:
529 GRAYSON LN
SEGUIN, TX
ZIP 78155
Phone: (254) 289-4071
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Nicole Jefferson is a residential treatment facility physical disabilities in Seguin, TX. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. Nicole Jefferson NPI is 1174023063. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

529 GRAYSON LN
SEGUIN, TX
ZIP 78155-084
Phone: (254) 289-4071
Fax: (830) 433-4219

The enumeration date for this NPI number is 2/16/2018 and was last updated on 8/13/2023.

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	Primary
1	3104A0625X	Assisted Living Facility	Assisted Living, Mental Illness	No
2	311ZA0620X	Custodial Care Facility	Adult Care Home	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness		No
4	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		No
5	320700000X	Residential Treatment Facility, Physical Disabilities		Yes
6	261QA0600X	Clinic/Center	Adult Day Care	No

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

NPI Synchronization or Removal

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