Provider Demographics
NPI:1700508884
Name:RAPTURE UNLIMITED LLC
Entity Type:Organization
Organization Name:RAPTURE UNLIMITED LLC
Other - Org Name:CHOSEN VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJUAN
Authorized Official - Middle Name:KENTRELL
Authorized Official - Last Name:LABORD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:346-475-1322
Mailing Address - Street 1:421 LINDA ST
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-1196
Mailing Address - Country:US
Mailing Address - Phone:682-372-7301
Mailing Address - Fax:
Practice Address - Street 1:421 LINDA ST
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-1196
Practice Address - Country:US
Practice Address - Phone:682-372-7301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No282E00000XHospitalsLong Term Care Hospital
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty