MEDICARE: SOUTH PLAINS COMMUNITY ACTION ASSOCIATION, 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	251E00000X	Home Health Agency	001599	TX

General Provider Information

NPI Number	:	1255497723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH PLAINS COMMUNITY ACTION ASSOCIATION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 610
Second Line	:
City	:	LEVELLAND
State	:	TX
Zip	:	79336-0610
Country	:	US
Telephone Number	:	806-894-6104
Fax Number	:	806-894-1621

Provider Business Practice Location Address
First Line	:	410 HOUSTON ST
Second Line	:
City	:	LEVELLAND
State	:	TX
Zip	:	79336-4044
Country	:	US
Telephone Number	:	806-894-7872
Fax Number	:	806-894-1621

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. WILLIAM D POWELL JR.
Credential	:
Telephone Number	:	806-894-6104

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	11/02/2023

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