VINTAGE SCC LLC NPI 1679718407

NPI Information

  • NPI: 1679718407
  • Provider Name: VINTAGE SCC LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: VINTAGE HEALTH CARE CENTER
  • CLIA Number: 45D0487302
  • Address: 205 N BONNIE BRAE ST
    DENTON, TX
    ZIP 76201
  • Phone: (940) 373-4766

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NPI Details

VINTAGE SCC LLC is an assisted living facility in Denton, TX. The provider is 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. VINTAGE SCC LLC NPI is 1679718407. The provider is registered as an organization entity type.
The provider Is Doing Business As Vintage Health Care Center.

The provider's business location address is:

205 N BONNIE BRAE ST
DENTON, TX
ZIP 76201-766
Phone: (940) 373-4766
Fax: (940) 320-6645

The provider's authorized official is Jason Price .
The authorized official title is Senior Vice President and has the following contact phone number (949) 436-4343.

The CLIA number assigned to this NPI record is 45D0487302 - skilled nursing facility/nursing facility with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/8/2008 and was last updated on 9/4/2020.

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
1310400000XAssisted Living FacilityTEXASYes

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
1000544OTHERTEXASFACILITY ID
2001017205MEDICAIDTEXAS

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: 11/21/2025

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