| Tri-state Area Behavioral Health Llc | |
|
1305 S Harvard St Perryton TX 79070-4412 | |
| (806) 202-8681 | |
| Not Available |
| Full Name | Tri-state Area Behavioral Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 1305 S Harvard St, Perryton, Texas |
| Authorized Official Name and Position | Kathi Boren (SOLE MEMBER) |
| Authorized Official Contact | 8062028681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Area Behavioral Health Llc 1305 S Harvard St Perryton TX 79070-4412 Ph: (806) 202-8681 | Tri-state Area Behavioral Health Llc 1305 S Harvard St Perryton TX 79070-4412 Ph: (806) 202-8681 |
| NPI Number | 1407561541 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Certification Date | 01/23/2023 |
| Medicare PECOS PAC ID | 8628421963 |
|---|---|
| Medicare Enrollment ID | O20240202000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407561541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kathi Boren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609258391 PECOS PAC ID: 3678926912 Enrollment ID: I20240202001051 |
Rhonda Graham M.ed., Lpc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1613 S Colgate St, Perryton, TX 79070 Phone: 480-634-0332 Fax: 806-434-2715 |