Organization
TEXAS PANHANDLE MENTAL HEALTH MENTAL RETARDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELLISA TALLEY (EXECUTIVE DIRECTOR)
(806) 351-3206
Entity
Organization
Contact information
Practice address
901 WALLACE BLVD, BUILDING 501, AMARILLO, TX 79106-1705
(806) 351-3200
(806) 351-3344
Mailing address
901 WALLACE BLVD, BUILDING 501, AMARILLO, TX 79106-1705
(806) 351-3200
(806) 351-3344
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127378102
—
TX
Enumeration date
03/20/2006
Last updated
09/29/2020
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