Provider Demographics
NPI:1205598380
Name:PANHANDLE INDEPENDENT LIVING CENTER
Entity type:Organization
Organization Name:PANHANDLE INDEPENDENT LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VETERAN OUTREACH COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERRIE
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-374-1400
Mailing Address - Street 1:417 SW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-3315
Mailing Address - Country:US
Mailing Address - Phone:806-374-1400
Mailing Address - Fax:806-374-4550
Practice Address - Street 1:417 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-3315
Practice Address - Country:US
Practice Address - Phone:806-374-1400
Practice Address - Fax:806-374-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management