Basic Information
| Provider Information | |||||||||
| NPI: | 1497165831 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PANHANDLE MENTAL HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4110 AVENUE D | ||||||||
| Address2: | |||||||||
| City: | SCOTTSBLUFF | ||||||||
| State: | NE | ||||||||
| PostalCode: | 693614650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3086353171 | ||||||||
| FaxNumber: | 3086320137 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 MAIN ST OFC A | ||||||||
| Address2: | |||||||||
| City: | OSHKOSH | ||||||||
| State: | NE | ||||||||
| PostalCode: | 691546112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3086332070 | ||||||||
| FaxNumber: | 3087723005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2014 | ||||||||
| LastUpdateDate: | 02/10/2016 | ||||||||
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| AuthorizedOfficialLastName: | RICHARDS | ||||||||
| AuthorizedOfficialFirstName: | LAURA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3086353171 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.