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General NPI Number Information
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NPI Number | 1215479399
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL MISSOURI CHILDREN'S ADVOCACY CENTER
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 906 MAIN ST
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City | TRENTON
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State | MO
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Zip | 64683-2199
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Country | US
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Telephone | 660-359-2874
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Fax | 660-359-2837
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Provider Business Mailing Address
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Address Line | 906 MAIN ST
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City | TRENTON
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State | MO
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Zip | 64683-2199
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Country | US
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Telephone | 660-359-2874
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Fax | 660-359-2837
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | VERNA M KELSEY
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Credential |
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Telephone | 660-359-2874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 002765
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License Number State | MO
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