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Judy Lynn Broyles
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Gladewater, Texas
NPI 1164046637

Judy Lynn Broyles is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Gladewater, TX. Judy Lynn Broyles practices in Gladewater, TX. The NPI Number for Judy Lynn Broyles is 1164046637 and holds a License No. (Texas).

The current practice location address for Judy Lynn Broyles is 1088 N Willow Oak Rd, Gladewater, TX and can be reached out via phone at 903-714-3099.

Location: 1088 N Willow Oak Rd, Gladewater, TX, 75647-7811
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164046637
Provider Name
Judy Lynn Broyles
Credential
Provider Entity Type
Individual
Gender
Female
Address
1088 N Willow Oak Rd, Gladewater, TX, 75647-7811
Phone Number
903-714-3099
Fax Number
Provider Enumeration Date
06/01/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1316559321 05 TX
institution
Provider Business Practice Location Address Details
Address
1088 N Willow Oak Rd
City
Gladewater
State
Texas
Zip
75647-7811
Phone Number
903-714-3099
Fax Number
person
Provider Business Mailing Address Details
Address
1088 N Willow Oak Rd
City
Gladewater
State
Texas
Zip
75647-7811
Phone Number
903-714-3099
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
()
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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