NPI 1013945898

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Organisation Intellectual Disabilities Intermediate Care Facility Jacksonville, TX

Practice location

Address: 5656 N. Jackson, Jacksonville, TX 75766
Phone: (903) 589-9000
Fax: (903) 586-9200

Authorised official

Name: Allyn Lang
Title: Executive Director
Phone: (903) 586-5507

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 45H269 (TX)

Other Intermediate Care Facility, Intellectual Disabilities providers in Texas →

Registry record

NPI: 1013945898
Entity type: Organization
NPI issued: 29 Jun 2006
Record last updated: 13 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.