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General NPI Number Information
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NPI Number | 1538571542
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Entity Type | Organization
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Legal Business Name | MOTHERS AGAINST METHAMPHETAMINE-OPENING DOORS TO RECOVERY
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Dates
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Enumeration Date | 05/25/2014
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Last Update Date | 05/25/2014
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Provider Practice Location Address
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Address Line | 17404 FREEDOM RD
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City | WILLOW SPRINGS
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State | MO
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Zip | 65793-7932
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Country | US
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Telephone | 417-469-0018
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Fax |
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Provider Business Mailing Address
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Address Line | 17404 FREEDOM RD
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City | WILLOW SPRINGS
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State | MO
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Zip | 65793-7932
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Country | US
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Telephone | 417-469-0018
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONNA BARBROW
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Credential |
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Telephone | 417-469-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | N01213043
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License Number State | MO
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