Basic Information
| Provider Information | |||||||||
| NPI: | 1093445801 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. FRANCIS COMMUNITY SERVICES IN TEXAS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 W OTIS AVE | ||||||||
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| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674018713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858250541 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 CHICAGO AVE | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794161605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858250541 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2022 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | PFANNENSTIEL | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINICAL SERVICES DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7856256651 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.