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General NPI Number Information
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NPI Number | 1568858645
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Entity Type | Organization
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Legal Business Name | JAMES MORGAN
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 1031 PERUQUE CROSSING CT
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City | O FALLON
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State | MO
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Zip | 63366-2362
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Country | US
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Telephone | 636-887-3655
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 PERUQUE CROSSING CT
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City | O FALLON
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State | MO
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Zip | 63366-2362
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Country | US
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Telephone | 636-887-3655
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Fax |
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Authorized Official
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Title or Position | PLPC
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Name | JAMES MORGAN
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Credential |
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Telephone | 618-304-6225
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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 | 2014004868
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License Number State | MO
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