East Texas Community Services for the Developmentally Disabled, Inc.
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Silsbee, TX
NPI 1477698488 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1477698488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 7413 (TX)
- Legal business name
- EAST TEXAS COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.
- Practice address
- 101 Oglesbee Rd
Silsbee, TX 77656-5925 - Phone
- (409) 385-5807
- Fax
- (409) 385-9304
- NPI assigned
- Feb 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. D Michael Johnson
- Title
- President
- Phone
- (409) 385-2626
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- East Texas Community Services for the Developmentally Disabled Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 7413 | TX | Yes |
Addresses
Primary practice location
101 Oglesbee Rd
Silsbee, TX 77656-5925
Mailing address
PO Box 2185
Silsbee, TX 77656-2185
Phone (409) 385-2626
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7413 | Other | TX | VENDOR |
Other names
- Woodlea Community Home
Other providers in Silsbee, TX
- Crystal Dorrell
- Anita L Drake
- Courtney Duhon
- Echo Dunaway
- Harold Dunn
- East Texas Community Services for the Developmentally Disabled, Inc.
- Kimberly Eaves
- Sandra D Ernst
- Francisco Nolen Esparza
- Meagan Luticia Ester
All providers in Silsbee, TX · Intellectual Disabilities Intermediate Care Facility in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.