Provider Demographics
NPI:1679681597
Name:PERMIAN BASIN COMMUNITY CENTERS FOR MHMR
Entity type:Organization
Organization Name:PERMIAN BASIN COMMUNITY CENTERS FOR MHMR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:432-570-3333
Mailing Address - Street 1:401 E ILLINOIS
Mailing Address - Street 2:STE 400
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701
Mailing Address - Country:US
Mailing Address - Phone:432-570-3333
Mailing Address - Fax:432-570-3344
Practice Address - Street 1:502 N CARVER
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701
Practice Address - Country:US
Practice Address - Phone:432-570-3333
Practice Address - Fax:432-570-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161373902Medicaid