Provider Demographics
NPI:1093926230
Name:PAMELA M. CHAMBERS
Entity Type:Organization
Organization Name:PAMELA M. CHAMBERS
Other - Org Name:MOSAICARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-570-5078
Mailing Address - Street 1:1623 HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-6904
Mailing Address - Country:US
Mailing Address - Phone:432-570-5078
Mailing Address - Fax:432-570-5078
Practice Address - Street 1:1623 HICKORY AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-6904
Practice Address - Country:US
Practice Address - Phone:432-570-5078
Practice Address - Fax:432-570-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities