CRESTWOOD SCC LLC NPI 1568607372

NPI Information

  • NPI: 1568607372
  • Provider Name: CRESTWOOD SCC LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: FREE STATE CRESTWOOD
  • Address: 1440 HOUSTON ST
    WILLS POINT, TX
    ZIP 75169
  • Phone: (903) 873-5400

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NPI Details

CRESTWOOD SCC LLC is an assisted living facility in Wills Point, TX. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. CRESTWOOD SCC LLC NPI is 1568607372. The provider is registered as an organization entity type.
The provider Is Doing Business As Free State Crestwood.

The provider's business location address is:

1440 HOUSTON ST
WILLS POINT, TX
ZIP 75169-135
Phone: (903) 873-5400
Fax: (903) 873-4404

The provider's authorized official is Michael Beal .
The authorized official title is Chief Executive Officer and has the following contact phone number (214) 252-7600.

The enumeration date for this NPI number is 12/8/2008 and was last updated on 3/5/2020.

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
1310400000XAssisted Living FacilityTEXASYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001017218MEDICAIDTEXAS
2030034OTHERTEXASFACILITY ID

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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