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NPI Code Detail

MEDICARE: AMARILLO COUNCIL ON ALCOHOLISM & DRUG ABUSE

MEDICARE: AMARILLO COUNCIL ON ALCOHOLISM & DRUG ABUSE
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center796TX

General Provider Information

NPI Number : 1386967552
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMARILLO COUNCIL ON ALCOHOLISM & DRUG ABUSE
Provider Business Mailing Address
First Line : 803 S RUSK ST
Second Line :
City : AMARILLO
State : TX
Zip : 79106-6648
Country : US
Telephone Number : 806-374-6688
Fax Number : 806-374-6938
Provider Business Practice Location Address
First Line : 803 S RUSK ST
Second Line :
City : AMARILLO
State : TX
Zip : 79106-6648
Country : US
Telephone Number : 806-374-6688
Fax Number : 806-374-6938
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. SAMANTHA G PATTERSON
Credential :
Telephone Number : 806-374-6688
Provider Enumeration Date : 03/02/2010
Last Update Date : 03/02/2010

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