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General NPI Number Information
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NPI Number | 1356630461
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Entity Type | Organization
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Legal Business Name | HORIZON OF HOPE
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 201 WEIR ST STE A
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City | LEADINGTON
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State | MO
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Zip | 63601-4474
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Country | US
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Telephone | 573-431-5903
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Fax | 573-431-5966
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Provider Business Mailing Address
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Address Line | PO BOX 647
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City | FARMINGTON
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State | MO
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Zip | 63640-0647
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Country | US
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Telephone | 573-431-5903
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Fax | 573-431-5966
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | MRS. TERRI LYNNE PATTERSON
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Credential | CCJP
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Telephone | 573-431-5903
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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 | 501839
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License Number State | MO
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