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NPI 1588692354 · Intellectual Disabilities Intermediate Care Facility · Jacksonville, TX
Provider details
- NPI number
- 1588692354
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Allyn Lang, Executive Director(903) 586-5507
- License
- 45H262 (TX)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
5656 N. Jackson
Jacksonville, TX 75766
Phone: (903) 589-9000
Fax: (903) 586-9200
Approximate (ZIP-level) locationGet directions
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.