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General NPI Number Information
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NPI Number | 1316989114
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Entity Type | Organization
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Legal Business Name | FARMINGTON MISSOURI HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 605 WALLACE RD
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City | FARMINGTON
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State | MO
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Zip | 63640-9217
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Country | US
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Telephone | 573-756-2108
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Fax | 573-756-1865
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Provider Business Mailing Address
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Address Line | 605 WALLACE RD
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City | FARMINGTON
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State | MO
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Zip | 63640-9217
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Country | US
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Telephone | 573-756-2108
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Fax | 573-756-1865
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Authorized Official
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Title or Position | SR VICE PRESIDENT
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Name | DEBBIE T BREWER
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Credential |
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Telephone | 877-892-9813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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