MEDICARE: TURTLE CREEK MANOR, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	264-A	TX
2	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1467595827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TURTLE CREEK MANOR, INC.

Provider Business Mailing Address
First Line	:	2820 SWISS AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-5958
Country	:	US
Telephone Number	:	214-522-7930
Fax Number	:	214-522-7952

Provider Business Practice Location Address
First Line	:	2707 ROUTH ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-1927
Country	:	US
Telephone Number	:	214-871-2483
Fax Number	:	214-871-3042

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JOHN E. CASTANEDA
Credential	:
Telephone Number	:	214-522-7930

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	09/11/2025

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