NPIMap

Organization Active NPI

Texas Panhandle Mental Health Mental Retardation

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Amarillo, TX
National Provider Identifier
1013362169
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
3610-3946 Issued in TX
Legal business name
TEXAS PANHANDLE MENTAL HEALTH MENTAL RETARDATION
Practice address
2002 Hardy St
Amarillo, TX 79106-2102
Phone
(806) 351-3200
Fax
(806) 351-3344
NPI assigned
Apr 26, 2016
Last updated
Sep 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mellisa Talley
Title
Executive Director
Phone
(806) 351-3206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 3610-3946 TX Primary

Addresses

Primary practice location

2002 Hardy St
Amarillo, TX 79106-2102

Mailing address

901 Wallace Blvd
Amarillo, TX 79106-1705
Phone (806) 351-3200

Other identifiers 2

IdentifierTypeStateIssuer
1134188139MedicaidTX
359864101MedicaidTX

Other names 1

  • TEXAS PANHANDLE CENTERS Other name

National Provider Directory

National Provider Directory
Tax ID family
Texas Panhandle Mental Health Mental Retardation13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2002 Hardy St
Amarillo, TX 79106
Phone (806) 351-3200

901 Wallace Blvd
Amarillo, TX 79106
Phone (806) 351-3200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1013362169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061705",
            "telephone_number": "806-351-3200",
            "fax_number": "806-351-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HARDY ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062102",
            "telephone_number": "806-351-3200",
            "fax_number": "806-351-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS PANHANDLE MENTAL HEALTH MENTAL RETARDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "TALLEY",
        "authorized_official_first_name": "MELLISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "806-351-3206"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "3610-3946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134188139",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "359864101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEXAS PANHANDLE CENTERS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "TEXAS PANHANDLE CENTERS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.