Healthcare Provider Details

I. General information

NPI: 1205967809
Provider Name (Legal Business Name): OZARK VALLEYS COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7070 NO. HIGHWAY 21
PILOT KNOB MO
63663-0494
US

IV. Provider business mailing address

7070 NO. HIGHWAY 21
PILOT KNOB MO
63663-0494
US

V. Phone/Fax

Practice location:
  • Phone: 573-546-2418
  • Fax: 573-546-4241
Mailing address:
  • Phone: 573-546-2418
  • Fax: 573-546-4241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDA ROBERTS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 573-546-2418