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General NPI Number Information
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NPI Number | 1306988043
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Entity Type | Organization
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Legal Business Name | CHALLENGE N' CHANGE, INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 429 N WASHINGTON ST
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City | NEVADA
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State | MO
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Zip | 64772-2346
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Country | US
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Telephone | 417-667-4315
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Fax | 417-667-4330
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Provider Business Mailing Address
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Address Line | 429 N WASHINGTON ST
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City | NEVADA
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State | MO
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Zip | 64772-2346
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Country | US
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Telephone | 417-667-4315
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GARLAND LEROY ADKINS
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Credential |
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Telephone | 417-667-4315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 0004444333
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License Number State | MO
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