Provider Demographics
NPI:1386967552
Name:AMARILLO COUNCIL ON ALCOHOLISM & DRUG ABUSE
Entity type:Organization
Organization Name:AMARILLO COUNCIL ON ALCOHOLISM & DRUG ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-374-6688
Mailing Address - Street 1:803 S RUSK ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-6648
Mailing Address - Country:US
Mailing Address - Phone:806-374-6688
Mailing Address - Fax:806-374-6938
Practice Address - Street 1:803 S RUSK ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-6648
Practice Address - Country:US
Practice Address - Phone:806-374-6688
Practice Address - Fax:806-374-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX796261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder