Provider Demographics
NPI:1649442310
Name:PERMIAN BASIN COMMUNITY CENTERS FOR MENTAL HEALTH & MENTAL RETARDATION
Entity type:Organization
Organization Name:PERMIAN BASIN COMMUNITY CENTERS FOR MENTAL HEALTH & MENTAL RETARDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:432-570-3369
Mailing Address - Street 1:401 E ILLINOIS AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-4803
Mailing Address - Country:US
Mailing Address - Phone:432-570-3333
Mailing Address - Fax:432-570-3426
Practice Address - Street 1:401 E ILLINOIS AVE
Practice Address - Street 2:STE 400
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-4803
Practice Address - Country:US
Practice Address - Phone:432-570-3333
Practice Address - Fax:432-570-3426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty