TAMARACK RESIDENTIAL SERVICES NPI 1396700423

NPI Information

  • NPI: 1396700423
  • Provider Name: TAMARACK RESIDENTIAL SERVICES
  • Classification: Intermediate Care Facility, Mental Illness - 310500000X
  • Entity Type: Organization
  • Other Name: BEVERLY
  • Address: 3730 E LOOP DR
    LONGVIEW, TX
    ZIP 75602
  • Phone: (903) 753-1979

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NPI Details

TAMARACK RESIDENTIAL SERVICES is an intermediate care facility mental illness in Longview, TX. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. TAMARACK RESIDENTIAL SERVICES NPI is 1396700423. The provider is registered as an organization entity type.
The provider Other Name Is Beverly.

The provider's business location address is:

3730 E LOOP DR
LONGVIEW, TX
ZIP 75602-704
Phone: (903) 753-1979
Fax: (903) 753-7485

The provider's authorized official is Mike Hawker .
The authorized official title is Cfo and has the following contact phone number (210) 340-7155.

The enumeration date for this NPI number is 4/20/2006 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310500000XIntermediate Care Facility, Mental Illness007599TEXASYes

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: 11/21/2025

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