NPI 1245427947

Breckenridge Village

Organisation Intellectual Disabilities Intermediate Care Facility Tyler, TX

Practice location

Address: 15062 County Road 1145, Tyler, TX 75704-7516
Phone: (903) 956-8100
Fax: (903) 596-8104

Authorised official

Name: Kevin King
Title: Executive Director
Phone: (903) 896-8100

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in Texas →

Registry record

NPI: 1245427947
Entity type: Organization
NPI issued: 27 Sep 2007
Record last updated: 26 Aug 2019

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.