Healthcare Provider Details

I. General information

NPI: 1598885931
Provider Name (Legal Business Name): OSAGE COUNTY SPECIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 E JEFFERSON ST
LINN MO
65051-0319
US

IV. Provider business mailing address

PO BOX 319 1006 E. JEFFERSON ST
LINN MO
65051-0319
US

V. Phone/Fax

Practice location:
  • Phone: 573-897-2991
  • Fax: 573-897-4760
Mailing address:
  • Phone: 573-897-2991
  • Fax: 573-897-4760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MEGAN K REICHART
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 573-897-2991