Healthcare Provider Details

I. General information

NPI: 1568498228
Provider Name (Legal Business Name): VALLEY HOPE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W ASHLEY RD
BOONVILLE MO
65233-0398
US

IV. Provider business mailing address

PO BOX 510 103 S WABASH AVE
NORTON KS
67654-0510
US

V. Phone/Fax

Practice location:
  • Phone: 660-882-6547
  • Fax: 660-882-2391
Mailing address:
  • Phone: 785-877-5111
  • Fax: 785-877-2322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KATHY ERBERT
Title or Position: DIRECTOR OF CONTRACT ADMINISTRATION
Credential:
Phone: 785-877-5111