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NPI 1013945898 · Intellectual Disabilities Intermediate Care Facility · Jacksonville, TX
Provider details
- NPI number
- 1013945898
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Allyn Lang, Executive Director
- License
- 45H269 (TX)
Practice location
5656 N. Jackson
Jacksonville, TX 75766
Phone: (903) 589-9000
Fax: (903) 586-9200
Mailing address
5656 N. Jackson
Jacksonville, TX 75766
Registry dates
- Enumerated
- 2006-06-29
- Last updated
- 2008-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.