Healthcare Provider Details

I. General information

NPI: 1982924775
Provider Name (Legal Business Name): JOURNEYS THROUGH AUTISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 OLD ROUTE 66 SUITEB
SAINT ROBERT MO
65584-4601
US

IV. Provider business mailing address

1106 OLD ROUTE 66 SUITEB
SAINT ROBERT MO
65584-4601
US

V. Phone/Fax

Practice location:
  • Phone: 573-336-4181
  • Fax: 573-336-2187
Mailing address:
  • Phone: 573-336-4181
  • Fax: 573-336-2187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number01140976
License Number StateMO

VIII. Authorized Official

Name: DR. CAROL E BARSBY
Title or Position: PROGRAM EXECUTIVE
Credential: EDD
Phone: 573-336-4181