Provider Demographics
NPI:1891084067
Name:AMES COUNSELING AND FAMILY SERVICES
Entity Type:Organization
Organization Name:AMES COUNSELING AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-754-9094
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:MOUNT ENTERPRISE
Mailing Address - State:TX
Mailing Address - Zip Code:75681-0696
Mailing Address - Country:US
Mailing Address - Phone:903-754-9094
Mailing Address - Fax:903-822-4252
Practice Address - Street 1:425 W SABINE ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633-2455
Practice Address - Country:US
Practice Address - Phone:903-754-9094
Practice Address - Fax:903-822-4252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16448251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLP0053183Medicaid