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EDUCARE COMMUNITY LIVING LIMITED PARTNERSHIP NPI 1083734024


NPI Information

NPI: 1083734024
Provider Name: EDUCARE COMMUNITY LIVING LIMITED PARTNERSHIP

Other Name: MTX COUNTRYVIEW

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
4666 SIERRA MADRE DR
WICHITA FALLS, TX
ZIP 76310
Phone: (817) 293-7575
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EDUCARE COMMUNITY LIVING LIMITED PARTNERSHIP is an intermediate care facility mentally retarded in Wichita Falls, TX. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. EDUCARE COMMUNITY LIVING LIMITED PARTNERSHIP NPI is 1083734024. The provider is registered as an organization entity type.
The provider Other Name Is Mtx Countryview.

The provider's business location address is:

4666 SIERRA MADRE DR
WICHITA FALLS, TX
ZIP 76310-568
Phone: (817) 293-7575

The provider's authorized official is Deena Ombres .
The authorized official title is Privacy Officer and has the following contact phone number (502) 394-2387.

The enumeration date for this NPI number is 3/31/2007 and was last updated on 7/14/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1001000430MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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