Healthcare Provider Details

I. General information

NPI: 1437504057
Provider Name (Legal Business Name): FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 05/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 N 22ND ST
SAINT JOSEPH MO
64506-2604
US

IV. Provider business mailing address

724 N 22ND ST
SAINT JOSEPH MO
64506-2604
US

V. Phone/Fax

Practice location:
  • Phone: 816-364-1501
  • Fax: 816-364-6735
Mailing address:
  • Phone: 816-364-1501
  • Fax: 816-364-6735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMY SPAETH
Title or Position: VP FINANCE
Credential:
Phone: 816-364-1501