Healthcare Provider Details

I. General information

NPI: 1316070212
Provider Name (Legal Business Name): PREFERRED FAMILY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E COMMERCIAL ST
KAHOKA MO
63445-1710
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 660-727-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number6300-9238
License Number StateMO

VIII. Authorized Official

Name: MARK CONOVER
Title or Position: CHIEF REVENUE OFFICER
Credential:
Phone: 573-603-1460