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BRIDGEWOOD LAKE JACKSON LLC NPI 1285985929


NPI Information

NPI: 1285985929
Provider Name: BRIDGEWOOD LAKE JACKSON, LLC

Doing Business As: CARRIAGE INN-LAKE JACKSON

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 45D2064408

Address:
211 E PARKWOOD AVE STE 100
FRIENDSWOOD, TX
ZIP 77546
Phone: (281) 996-0101
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BRIDGEWOOD LAKE JACKSON, LLC is an assisted living facility in Friendswood, 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. BRIDGEWOOD LAKE JACKSON, LLC NPI is 1285985929. The provider is registered as an organization entity type.
The provider Is Doing Business As Carriage Inn-lake Jackson.

The provider's business location address is:

211 E PARKWOOD AVE STE 100
FRIENDSWOOD, TX
ZIP 77546-152
Phone: (281) 996-0101
Fax: (281) 996-1141

The provider's authorized official is James D. Gray .
The authorized official title is Manager and has the following contact phone number (713) 623-6767.

The CLIA number assigned to this NPI record is 45D2064408 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2012 and was last updated on 9/20/2012.


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
1311500000XAlzheimer Center (Dementia Center)No
2310400000XAssisted Living FacilityYes

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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