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General NPI Number Information
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NPI Number | 1376177444
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Entity Type | Organization
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Legal Business Name | RAISING A VILLAGE, INC
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 103 STRAUSS DR
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City | PARK HILLS
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State | MO
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Zip | 63601-2400
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Country | US
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Telephone | 573-664-4458
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Fax |
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Provider Business Mailing Address
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Address Line | 103 STRAUSS DR
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City | PARK HILLS
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State | MO
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Zip | 63601-2400
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Country | US
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Telephone | 573-664-4458
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/PRESIDENT
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Name | JESSICA NORTON
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Credential |
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Telephone | 573-664-4458
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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