OrganizationActive
Creative Community Care
NPI 1992844757 · Intellectual Disabilities Intermediate Care Facility · Tyler, TX
Provider details
- NPI number
- 1992844757
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Laura Redman, Ceo
Practice location
1611 E 5th St
Tyler, TX 75701-3432
Phone: (903) 595-5644
Fax: (903) 526-0881
Mailing address
1611 E 5th St
Tyler, TX 75701-3432
Registry dates
- Enumerated
- 2007-02-06
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.