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General NPI Number Information
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NPI Number | 1538604715
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Entity Type | Organization
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Legal Business Name | ANDREWS CENTER -PINKERTON
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 2323 W FRONT ST
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City | TYLER
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State | TX
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Zip | 75702-7704
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Country | US
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Telephone | 903-597-1351
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Fax |
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Provider Business Mailing Address
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Address Line | 210 S PINKERTON ST
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City | ATHENS
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State | TX
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Zip | 75751-2439
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Country | US
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Telephone | 903-675-2140
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JASON BERRYHILL
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Credential |
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Telephone | 903-597-1351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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