Provider Demographics
NPI:1255497723
Name:SOUTH PLAINS COMMUNITY ACTION ASSOCIATION, INC.
Entity Type:Organization
Organization Name:SOUTH PLAINS COMMUNITY ACTION ASSOCIATION, INC.
Other - Org Name:COMMUNITY ACTION HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:806-894-6104
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-0610
Mailing Address - Country:US
Mailing Address - Phone:806-894-6104
Mailing Address - Fax:806-894-1621
Practice Address - Street 1:410 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-4044
Practice Address - Country:US
Practice Address - Phone:806-894-7872
Practice Address - Fax:806-894-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001599251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457719Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER NUMB