Educare Community Living Limited Partnership

NPI #1023138062 in Tyler, Texas

Provider Information

NPI Number: 1023138062
Entity Type: Organization
Organization Name: Educare Community Living Limited Partnership
Primary Specialty: Intermediate Care Facility, Intellectual Disabilities
Enumeration Date: Mar 31, 2007
Last Updated: May 28, 2019

Practice Location

Address: 15062 COUNTY ROAD 1145
City: Tyler
State: Texas
ZIP Code: 75704-7516
Phone: (502) 394-2100

Authorized Official

Name: MR. TIMOTHY TYLER WHOBREY
Title: PROVIDER ENROLLMENT
Phone: (502) 630-7249

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Intermediate Care Facility, Intellectual Disabilities	315P00000X	Primary

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