Provider Demographics
NPI:1578631024
Name:COMMUNITY ACCESS, INC
Entity Type:Organization
Organization Name:COMMUNITY ACCESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-595-5644
Mailing Address - Street 1:2040 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-2612
Mailing Address - Country:US
Mailing Address - Phone:903-595-5644
Mailing Address - Fax:903-526-0881
Practice Address - Street 1:2040 SHILOH RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2612
Practice Address - Country:US
Practice Address - Phone:903-595-5644
Practice Address - Fax:903-526-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility