Healthcare Provider Details

I. General information

NPI: 1073661682
Provider Name (Legal Business Name): OZARK CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 MC CLELLAND BLVD
JOPLIN MO
64804-1637
US

IV. Provider business mailing address

PO BOX 2526
JOPLIN MO
64803-2526
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-7600
  • Fax: 417-347-7608
Mailing address:
  • Phone: 417-347-7600
  • Fax: 417-347-7608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number3070-8702
License Number StateMO

VIII. Authorized Official

Name: MARY B. PARRIGON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 417-347-7600