LONE STAR DAY PROGRAM , NPI 1801210505 — TYLER (TX)

NPI 1801210505

6+ Years Experience Organization

LONE STAR DAY PROGRAM

02/17/2014
PROVIDER ENUMERATION DATE
07.05.2018
LAST UPDATE DATE
1801210505
NPI NUMBER

About LONE STAR DAY PROGRAM

LONE STAR DAY PROGRAM is a provider established in TYLER, TX. The NPI number of LONE STAR DAY PROGRAM is 1801210505 and was assigned on 02/17/2014. The practitioners primary taxonomy code is: 261QD1600X .

Mailing address

  • City: LINDALE
  • State: TX
  • Postal code: 75771
  • Phone: 4302352089
  • Fax: 4302352087
  • Address: PO BOX 1168

Primary Practice Address

  • Region : TYLER, TX
  • NPI : 1801210505
  • Phone : 4302352089
  • Fax : 4302352087
  • Postalcode : 75706
  • Address : 14864 COUNTY ROAD 433

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QD1600X

The taxonomy is not the primary taxonomy.

Taxonomy description: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

Healthcare provider taxonomy #2 - Behavior Analyst

  • Taxonomy code: 103K00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A behavior analyst is qualified by at least a master"s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Contacts:

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  • LONE STAR DAY PROGRAM
  • Address : 14864 COUNTY ROAD 433
  • Region : TYLER, TX
  • NPI : 1801210505
  • Phone : 4302352089
  • Fax : 4302352087
  • Postalcode : 75706

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 4302352089
  • Title or position : COORDINATOR

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address14864 COUNTY ROAD 433
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameTYLER
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code75706
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4302352089
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4302352087
The fax number associated with the location address of the provider being identified.
NPI1801210505
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QD1600X
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Provider Enumeration Date02/17/2014
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.05.2018
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)LONE STAR DAY PROGRAM
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 1168
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameLINDALE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code75771
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4302352089
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number4302352087
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameTUTTON
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameBELINDA
The first name of the authorized official
Authorized Official Title or PositionCOORDINATOR
The title or position of the authorized official
Authorized Official Telephone Number4302352089
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QD1600X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2103K00000X
Healthcare Provider Taxonomy 2Behavior Analyst
A behavior analyst is qualified by at least a master"s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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