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General NPI Number Information
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NPI Number | 1508067141
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Entity Type | Organization
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Legal Business Name | SAMARITAN PASTORAL COUNSELING CENTER OF AMARILLO, INC.
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 112 W 8TH AVE STE 800
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City | AMARILLO
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State | TX
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Zip | 79101-2399
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Country | US
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Telephone | 806-353-1668
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Fax |
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Provider Business Mailing Address
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Address Line | 3517 S MILAM ST
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City | AMARILLO
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State | TX
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Zip | 79109-4824
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Country | US
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Telephone | 806-359-0277
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. TWILLA WOOLSEY
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Credential | M.S. LMFTA
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Telephone | 806-353-1668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12516
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License Number State | TX
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