Provider Demographics
NPI:1639297799
Name:HELEN FARABEE CENTERS
Entity Type:Organization
Organization Name:HELEN FARABEE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-397-3140
Mailing Address - Street 1:PO BOX 8266
Mailing Address - Street 2:1000 BROOK AVE
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76307-8266
Mailing Address - Country:US
Mailing Address - Phone:940-397-3140
Mailing Address - Fax:940-397-3150
Practice Address - Street 1:1000 BROOK AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5007
Practice Address - Country:US
Practice Address - Phone:940-397-3140
Practice Address - Fax:940-397-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127373201Medicaid