Healthcare Provider Details
I. General information
NPI: 1366385494
Provider Name (Legal Business Name): TEAM BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1215 S 1ST ST
EL DORADO SPRINGS MO
64744-1862
US
IV. Provider business mailing address
1800 S PARK ST
EL DORADO SPRINGS MO
64744-2200
US
V. Phone/Fax
- Phone: 417-576-0845
- Fax:
- Phone: 417-576-0845
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 322D00000X |
| Taxonomy | Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DUSTIN
EUGENE
SHUMAKER
Title or Position: OWNER
Credential:
Phone: 417-576-0845