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General NPI Number Information
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NPI Number | 1497956858
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL CENTER OF THE OZARKS
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 1545 E PYTHIAN ST
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City | SPRINGFIELD
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State | MO
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Zip | 65802-2139
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Country | US
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Telephone | 417-829-0893
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Fax | 417-831-7539
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Provider Business Mailing Address
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Address Line | 1545 E PYTHIAN ST
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City | SPRINGFIELD
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State | MO
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Zip | 65802-2139
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Country | US
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Telephone | 417-829-0893
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Fax | 417-831-7539
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ALLAN MCKELVY
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Credential |
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Telephone | 417-829-0893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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