Organization
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Active
Other names
ResourceCare Clyde
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA LOUISE BETCHER (BILLING MANAGER/CREDENTIALER)
(325) 893-4010
Entity
Organization
Contact information
Practice address
1712 NORTH ACCESS ROAD, CLYDE, TX 79510
(325) 893-4010
(325) 893-4035
Mailing address
PO BOX 2435, ALBANY, TX 76430-8020
(325) 762-2447
(325) 762-2186
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
30117281979
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287755701
—
TX
Enumeration date
12/06/2011
Last updated
10/30/2012
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