Breckenridge Village Mallard House

LBN: Breckenridge Village
Breckenridge Village Mallard House is an health care organization with primary practice located at 15062 County Road 1145 , Tyler TX 75704-7516. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Breckenridge Village can be contacted via phone (903) 956-8100, or through King, Kevin via phone (903) 896-8100.

Contact Information

Primary practice address
15062 County Road 1145 Tyler TX 75704-7516
Phone: (903) 956-8100
Fax: (903) 596-8104
Website:
Map and Directions
Authorized official contact:
Name: King, Kevin
Phone: (903) 896-8100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1245427947
LBN Legal business name Breckenridge Village
DBA Doing business as Breckenridge Village Mallard House
Authorized official King, Kevin
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 27th, 2007
Last updated Aug 26th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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