JUDY LYNN BROYLES (NPI# 1164046637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164046637 |
Entity Type | Individual |
Full Name | JUDY LYNN BROYLES |
Practice Address |
1088 N Willow Oak Rd Gladewater TX 75647-7811 |
Practice Telephone | 9037143099 |
Mailing Telephone | 9037143099 |
Enumeration Date | 2020-06-01 |
Last Update Date | 2020-07-20 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251E00000X | Home Health | Agencies | ||
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
1088 N WILLOW OAK RD |
City | GLADEWATER |
State | TX |
Zip Code | 75647-7811 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316559321 | B &g Custom Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1088 Willow Oak Rd, Gladewater, TX 75647 | 2020-08-20 |
1578866182 | Easttexrx LLC | Pharmacy | 402b W Upshur, Gladewater, TX 75647 | 2010-12-21 |
1518173285 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 2402 Woodbine, Gladwater, TX 75647 | 2007-05-16 |
1407921638 | Michael Ray Ellis | Dentist | 406 West Upshur Ave, Gladewater, TX 75647 | 2006-11-22 |
1811087356 | Walker Pharmacy | Pharmacy | 402 B W Upshur, Gladewater, TX 75647 | 2006-10-13 |
1508953399 | Legend Healthcare Gladewater, Lp | Skilled Nursing Facility | 1201 Fm 2685, Gladewater, TX 75647 | 2006-10-05 |
1720033517 | L-m-r Health Care Services Inc | Intermediate Care Facility, Mentally Retarded | 502 Tenery St, Gladewater, TX 75647 | 2006-05-23 |
1093172785 | Tracy Casey | Nurse Practitioner | 1600 Broadway Ave, Gladewater, TX 75647 | 2016-01-26 |
1851434237 | Union Grove Isd | Local Education Agency (LEA) | Old Hwy 271 S, Gladewater, TX 75647-1447 | 2007-02-15 |
1164957692 | Jolene Ackley | Private Vehicle | 500 W Marshall Ave, Gladewater, TX 75647-2110 | 2017-04-21 |
Find all providers in zip 75647 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316559321 | B &g Custom Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1088 Willow Oak Rd, Gladewater, TX 75647 | 2020-08-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750980686 | Mimshack Care Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12330 Springcrest Dr, Houston, TX 77072-3219 | 2020-10-21 |
1679172936 | Re-care Incorporated | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 200 University Blvd Ste 225-374, Round Rock, TX 78665-1001 | 2020-10-19 |
1407454176 | Viandsa Care Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17203 Quiet Song Ct, Richmond, TX 77407-2964 | 2020-10-14 |
1053919050 | Building Bridges In Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2007 Liberty Cove Ct, Richmond, TX 77469-2338 | 2020-10-12 |
1497353635 | Helping Hearts Residential Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 20319 Bridge Manor Ln, Richmond, TX 77407-6494 | 2020-10-10 |
1750989067 | Able Wisdom Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2203 Huntington Dr, Wylie, TX 75098-7164 | 2020-10-09 |
1518573609 | Jbk House of Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2624 Grand Gulf Rd, Fort Worth, TX 76123-2613 | 2020-09-23 |
1700492352 | St Monica Healthcare Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11311 Scottsdale Dr, Meadows Place, TX 77477-1811 | 2020-09-18 |
1265047534 | Compassion Structured Living Center LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13578 San Martin Ln, Houston, TX 77083-5135 | 2020-09-13 |
1497369474 | Nexphase Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1201 N Watson Rd Ste 205, Arlington, TX 76006-6120 | 2020-09-07 |
Find all providers with the same taxonomy |
City | GLADEWATER |
Zip Code | 75647 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.