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General NPI Number Information
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NPI Number | 1659002210
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Entity Type | Organization
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Legal Business Name | OZARK CENTER
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 1949 SNOWBERRY LN
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City | JOPLIN
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State | MO
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Zip | 64804-5420
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Country | US
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Telephone | 417-347-7860
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2526
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City | JOPLIN
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State | MO
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Zip | 64803-2526
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Country | US
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Telephone | 417-347-7670
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Fax | 417-347-0048
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Authorized Official
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Title or Position | DIRECTOR. CREDENTIALING
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Name | TEENA MAITLAND
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Credential |
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Telephone | 417-347-7670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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