Provider Demographics
NPI:1336334168
Name:ABILENE REGIONAL MHMR CENTER
Entity type:Organization
Organization Name:ABILENE REGIONAL MHMR CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALIVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-690-5131
Mailing Address - Street 1:2616 S CLACK ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1557
Mailing Address - Country:US
Mailing Address - Phone:325-690-5131
Mailing Address - Fax:325-690-5228
Practice Address - Street 1:765 ORANGE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5011
Practice Address - Country:US
Practice Address - Phone:325-690-5131
Practice Address - Fax:325-690-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services