Healthcare Provider Details

I. General information

NPI: 1871780767
Provider Name (Legal Business Name): CHILDREN'S THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 TOWER RD.
WARSAW MO
65355
US

IV. Provider business mailing address

1500 EWING DR
SEDALIA MO
65301-2396
US

V. Phone/Fax

Practice location:
  • Phone: 660-826-4400
  • Fax: 660-827-5869
Mailing address:
  • Phone: 660-826-4400
  • Fax: 660-827-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ANN GRAFF
Title or Position: EXECUTIVE DIRECTOR/CEO
Credential:
Phone: 660-826-4400