| West Pines On Golden Pond | |
|
7480 Golden Pond Pl Suite 400 Amarillo TX 79121-1962 | |
| (806) 354-9996 | |
| (806) 354-9995 |
| Full Name | West Pines On Golden Pond |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7480 Golden Pond Pl, Amarillo, Texas |
| Authorized Official Name and Position | Gerald W Rogers (OWNER) |
| Authorized Official Contact | 8063549996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Pines On Golden Pond Po Box 50660 Amarillo TX 79159-0660 Ph: (806) 354-9996 | West Pines On Golden Pond 7480 Golden Pond Pl Suite 400 Amarillo TX 79121-1962 Ph: (806) 354-9996 |
| NPI Number | 1033444328 |
|---|---|
| Provider Enumeration Date | 10/05/2009 |
| Last Update Date | 10/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033444328 | NPI | - | NPPES |
| 154282 | Other | TX | VALUE OPTIONS |
| 064242301 | Medicaid | TX | |
| 122754101 | Other | TX | FIRST CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2622 (Texas) | Secondary |
| 1041C0700X | Social Worker - Clinical | 00732 (Texas) | Primary |
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