ST. GILES LIVING CENTERS, INC. (NPI# 1568063527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568063527 |
| Entity Type | Organization |
| Organization Name | ST. GILES LIVING CENTERS, INC. |
| Practice Address |
2525 Preston Ave Tyler TX 75701-4644 |
| Mailing Address |
4800 Overton Plz Ste 440 Fort Worth TX 76109-4435 |
| Practice Telephone | 8002995161 |
| Practice Fax Number | 8174473033 |
| Mailing Telephone | 8002995161 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | ANNA TODD (OPERATIONS BUSINESS MANAGER) |
| Authorized Official Telephone | 8002995161 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. GILES LIVING CENTERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| 2525 Preston Avenue | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639271 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3323 Gail Ln, Tyler, TX 75701-7425 | 2020-11-05 |
| 1952902900 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2500 Terry Pl, Greenville, TX 75402-7131 | 2020-11-05 |
| 1811598865 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 100 Patti J St, Greenville, TX 75402-8053 | 2020-11-05 |
| 1124629175 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2616 Pounds Ave, Tyler, TX 75701-5627 | 2020-11-05 |
| 1104427509 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2812 Shaffer Ln, Tyler, TX 75702-1653 | 2020-11-03 |
| 1265033658 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3506 Garber Cir, Greenville, TX 75402-6234 | 2020-11-03 |
| 1487255873 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3600 New Copeland Rd, Tyler, TX 75701-8839 | 2020-11-03 |
| 1194893180 | St. Giles Living Centers, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3010 S 1st St, Lufkin, TX 75901-7110 | 2006-11-30 |
| Street Address |
2525 PRESTON AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-4644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639271 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3323 Gail Ln, Tyler, TX 75701-7425 | 2020-11-05 |
| 1124629175 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2616 Pounds Ave, Tyler, TX 75701-5627 | 2020-11-05 |
| 1104427509 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2812 Shaffer Ln, Tyler, TX 75702-1653 | 2020-11-03 |
| 1487255873 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3600 New Copeland Rd, Tyler, TX 75701-8839 | 2020-11-03 |
| 1023138062 | Educare Community Living Limited Partnership | Intermediate Care Facility, Mentally Retarded | 15062 County Road 1145, Tyler, TX 75704-7516 | 2007-03-31 |
| 1245427947 | Breckenridge Village | Intermediate Care Facility, Mentally Retarded | 15062 County Road 1145, Tyler, TX 75704-7516 | 2007-09-27 |
| 1477748010 | Breckenridge Village | Intermediate Care Facility, Mentally Retarded | 15062 County Road 1145, Tyler, TX 75704-7516 | 2007-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902900 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2500 Terry Pl, Greenville, TX 75402-7131 | 2020-11-05 |
| 1811598865 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 100 Patti J St, Greenville, TX 75402-8053 | 2020-11-05 |
| 1265033658 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3506 Garber Cir, Greenville, TX 75402-6234 | 2020-11-03 |
| 1306446000 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 6520 Braddock Pl, Dallas, TX 75232-2902 | 2020-10-30 |
| 1578179750 | Keondra C Johnson | Intermediate Care Facility, Mentally Retarded | 2140 Medical District Dr Apt 2052, Dallas, TX 75235-8097 | 2020-09-22 |
| 1467062869 | Affluent Health Care Services Inc. | Intermediate Care Facility, Mentally Retarded | 7542 Autumn Sun Dr, Houston, TX 77083-6915 | 2020-07-31 |
| 1053951772 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 1809 Auburn Dr, Richardson, TX 75081-3123 | 2020-01-10 |
| 1124668850 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 2100 Cedar Cir, Carrollton, TX 75006-1922 | 2020-01-10 |
| 1295375913 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 974 E Cedar St, Seguin, TX 78155-3844 | 2020-01-10 |
| 1033759758 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 4801 Bermuda Dr, San Angelo, TX 76904-7204 | 2020-01-10 |
| Find all providers with the same taxonomy | ||||
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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.