SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER NPI 1417248824

NPI Information

NPI: 1417248824
Provider Name: SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER

Doing Business As: RESOURCECARE BRECKENRIDGE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2802 W WALKER ST
BRECKENRIDGE, TX
ZIP 76424
Phone: (254) 559-7215
Get Directions

SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER is a federally qualified health center (fqhc) clinic center in Breckenridge, TX. SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER NPI is 1417248824. The provider is registered as an organization entity type.
The provider Is Doing Business As Resourcecare Breckenridge.

The provider's business location address is:

2802 W WALKER ST
BRECKENRIDGE, TX
ZIP 76424-000
Phone: (254) 559-7215
Fax: (254) 559-7213

The provider's authorized official is Tina Louise Betcher .
The authorized official title is Billing Manager/credentialer and has the following contact phone number (325) 893-4010.

The CLIA number assigned to this NPI record is 45D1041811 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/20/2011 and was last updated on 10/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	30117281979	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	171901504	MEDICAID	TEXAS
2	671831	MEDICARE OSCAR/CERTIFICATION	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »