NPIMap

Organization Active NPI

Andrews Center/ Phillips

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Tyler, TX
National Provider Identifier
1063436665
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
ANDREWS CENTER/ PHILLIPS
Practice address
210 W Phillips St
Tyler, TX 75701-1642
Phone
(903) 593-8861
NPI assigned
Jul 27, 2006
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Randa Haywood
Title
Cfo
Phone
(903) 597-1351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

210 W Phillips St
Tyler, TX 75701-1642

Mailing address

210 W Phillips St
Tyler, TX 75701-1642
Phone (903) 593-8861

Other identifiers 1

IdentifierTypeStateIssuer
000377601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519001179 TX Part B Supplier - Clinic/Group Practice 9739170770 Receives reassigned benefits from 71 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tyler, TX; Mineola, TX; Canton, TX; Athens, TX; Emory, TX

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Andrews Center-Adt21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1063436665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W PHILLIPS ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011642",
            "telephone_number": "903-593-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W PHILLIPS ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011642",
            "telephone_number": "903-593-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREWS CENTER/ PHILLIPS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "HAYWOOD",
        "authorized_official_first_name": "RANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "903-597-1351"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000377601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.