Provider Demographics
NPI:1093709222
Name:ABILENE PSYCHIATRIC CENTER INC
Entity Type:Organization
Organization Name:ABILENE PSYCHIATRIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:R
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-642-7460
Mailing Address - Street 1:PO BOX 5559
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5559
Mailing Address - Country:US
Mailing Address - Phone:325-698-6600
Mailing Address - Fax:325-698-8200
Practice Address - Street 1:4225 WOODS PL
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7991
Practice Address - Country:US
Practice Address - Phone:325-698-6600
Practice Address - Fax:325-698-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007827283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454098Medicare ID - Type Unspecified