Provider Demographics
NPI:1770661050
Name:REGION 16 EDUCATION SERVICE CENTER
Entity Type:Organization
Organization Name:REGION 16 EDUCATION SERVICE CENTER
Other - Org Name:REGION 16 EARLY CHILDHOOD INTERVENTION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-677-5000
Mailing Address - Street 1:5800 BELL ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6230
Mailing Address - Country:US
Mailing Address - Phone:806-677-5224
Mailing Address - Fax:806-677-5223
Practice Address - Street 1:5800 BELL ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6230
Practice Address - Country:US
Practice Address - Phone:806-677-5224
Practice Address - Fax:806-677-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017409601Medicaid
TX017409601MedicaidTCM MEDICAID ID