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General NPI Number Information
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NPI Number | 1194251975
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Entity Type | Organization
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Legal Business Name | MADISON COUNTY SERVICE COORDINATION INC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 610 S CHAMBER DR STE B
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-1742
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Country | US
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Telephone | 573-783-4451
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Fax | 573-783-3665
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Provider Business Mailing Address
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Address Line | 610 S CHAMBER DR STE B
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-1742
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Country | US
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Telephone | 573-783-4451
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Fax | 573-783-3665
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Authorized Official
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Title or Position | SERVICE COORDINATION DIRECTOR
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Name | ELIZABETH BAUGH
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Credential | LMSW
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Telephone | 573-783-4451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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