OrganizationActive
Breckenridge Village
NPI 1245427947 · Intellectual Disabilities Intermediate Care Facility · Tyler, TX
Provider details
- NPI number
- 1245427947
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Baptist Child & Family Services Inc.
- Organization subpart
- Yes
- Authorized official
- Kevin King, Executive Director(903) 896-8100
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15062 County Road 1145
Tyler, TX 75704-7516
Phone: (903) 956-8100
Fax: (903) 596-8104
Street-level locationGet directions
Mailing address
15062 County Road 1145
Tyler, TX 75704-7516
Other names (DBA / former)
- Doing business as
- Breckenridge Village Mallard House
- Doing business as
- Breckenridge Village Mallard House
Registry dates
- Enumerated
- 2007-09-27
- Last updated
- 2019-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.