OrganizationActive
Breckenridge Village
NPI 1477748010 · Intellectual Disabilities Intermediate Care Facility · Tyler, TX
Provider details
- NPI number
- 1477748010
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Melissa Perkins, President(903) 596-8100
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
15062 County Road 1145
Tyler, TX 75704-7516
Phone: (903) 956-8100
Fax: (903) 956-8104
Approximate (ZIP-level) locationGet directions
Mailing address
15062 County Road 1145
Tyler, TX 75704-7516
Other names (DBA / former)
- Doing business as
- Breckenridge Village of Tyler
- Doing business as
- Breckenridge Village of Tyler
Registry dates
- Enumerated
- 2007-09-06
- Last updated
- 2025-04-28
- Certified
- 2025-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.