Healthcare Provider Details
I. General information
NPI: 1770661050
Provider Name (Legal Business Name): REGION 16 EDUCATION SERVICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5800 BELL ST
AMARILLO TX
79109-6230
US
IV. Provider business mailing address
5800 BELL ST
AMARILLO TX
79109-6230
US
V. Phone/Fax
- Phone: 806-677-5224
- Fax: 806-677-5223
- Phone: 806-677-5224
- Fax: 806-677-5223
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
LANCE
TERRELL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 806-677-5000