NPIMap

Organization Active NPI

Baptist Care Facilities for Person'S With Mental Disabilties

  • Assisted Living Facility
  • Tyler, TX
National Provider Identifier
1770969768
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
137372 Issued in TX
Legal business name
BAPTIST CARE FACILITIES FOR PERSON'S WITH MENTAL DISABILTIES
Practice address
15062 County Road 1145
Tyler, TX 75704-7516
Phone
(903) 596-8100
Fax
(903) 596-8104
NPI assigned
Aug 3, 2015
Organization subpart
Yes
Parent organization
BCFS HHSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Authorized official

Name
Kevin King, LCCA
Title
Executive Director
Phone
(903) 596-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 137372 TX Primary

Addresses

Primary practice location

15062 County Road 1145
Tyler, TX 75704-7516

Mailing address

15062 County Road 1145
Tyler, TX 75704-7516
Phone (903) 596-8100

Other names 1

  • Breckenridge Village of Tyler Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baptist Care Facilities for Person'S With Mental Disabilties3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1770969768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15062 COUNTY ROAD 1145",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757047516",
            "telephone_number": "903-596-8100",
            "fax_number": "903-596-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15062 COUNTY ROAD 1145",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757047516",
            "telephone_number": "903-596-8100",
            "fax_number": "903-596-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST CARE FACILITIES FOR PERSON'S WITH MENTAL DISABILTIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BCFS HHS",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "903-596-8100",
        "authorized_official_credential": "LCCA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "137372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breckenridge Village of Tyler",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.