Organization
TEXAS PANHANDLE MHMR
Active
Other names
Early Childhood Intervention
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH HERNANDEZ (REIMBURSEMENT OFFICER 1)
(806) 677-2109
Entity
Organization
Contact information
Practice address
901 WALLACE BLVD, AMARILLO, TX 79106-1705
(806) 358-8974
(806) 359-0506
Mailing address
PO BOX 3250, AMARILLO, TX 79116-3250
(806) 358-8974
(806) 359-0506
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
TX
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
TX
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017421101
—
TX
Enumeration date
04/16/2007
Last updated
05/03/2022
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