Healthcare Provider Details
I. General information
NPI: 1477883643
Provider Name (Legal Business Name): FINCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2010
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
304 E JACKSON ST STE. 204
WILLARD MO
65781-9333
US
IV. Provider business mailing address
PO BOX 1
WILLARD MO
65781-0001
US
V. Phone/Fax
- Phone: 417-685-4208
- Fax: 417-751-9118
- Phone: 417-685-4208
- Fax: 417-751-9118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 2004036292 |
| License Number State | MO |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
SARAH
L.
KING-FINLEY
Title or Position: DIRECTOR
Credential: LPC
Phone: 417-751-9119