NPI: 1003481086 · JEFFERSON, TX 75657 · Assisted Living Facility · NPI assigned 05/23/2021
| Authorized Official | MOMAN, MATTHEW (PRESIDENT) |
| NPI Enumeration Date | 05/23/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 83 | $25K |
| 2022 | 595 | $193K |
| 2023 | 620 | $242K |
| 2024 | 218 | $117K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 1,516 | 461 | $578K |