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General NPI Number Information
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NPI Number | 1609806579
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Entity Type | Organization
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Legal Business Name | LEE BIVINS FOUNDATION
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 6600 KILLGORE DR
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City | AMARILLO
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State | TX
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Zip | 79106-3700
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Country | US
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Telephone | 806-350-2200
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Fax | 806-354-8537
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Provider Business Mailing Address
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Address Line | PO BOX 1727
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City | AMARILLO
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State | TX
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Zip | 79105-1727
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Country | US
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Telephone | 806-379-9400
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Fax | 806-379-9404
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Authorized Official
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Title or Position | CFO
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Name | MR. PAUL J SNEED
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Credential |
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Telephone | 806-379-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 112385
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License Number State | TX
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