Healthcare Provider Details

I. General information

NPI: 1790818698
Provider Name (Legal Business Name): PREFERRED FAMILY HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 S WASHINGTON ST
CHILLICOTHEE MO
64601-3028
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 660-646-4226
  • Fax: 660-646-2662
Mailing address:
  • Phone: 660-665-1962
  • Fax: 660-665-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number6300-9238
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number6300-9238
License Number StateMO

VIII. Authorized Official

Name: MR. MICHAEL SCHWEND
Title or Position: CEO
Credential:
Phone: 660-665-1962