Provider Demographics
NPI:1891754222
Name:TYRRELL ADULT CARE
Entity Type:Organization
Organization Name:TYRRELL ADULT CARE
Other - Org Name:TYRRELL ADULT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EPPIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:409-350-9933
Mailing Address - Street 1:5733 MEL SHA LN
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-6806
Mailing Address - Country:US
Mailing Address - Phone:409-350-9933
Mailing Address - Fax:409-840-9435
Practice Address - Street 1:5733 MEL SHA LN
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-6806
Practice Address - Country:US
Practice Address - Phone:409-350-9933
Practice Address - Fax:409-840-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home