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General NPI Number Information
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NPI Number | 1699604587
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Entity Type | Organization
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Legal Business Name | SHOUSE THERAPEUTIC BEHAVIORAL CENTER
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Dates
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Enumeration Date | 05/16/2026
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Last Update Date | 05/16/2026
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Provider Practice Location Address
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Address Line | 2616 E BATTLEFIELD RD
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City | SPRINGFIELD
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State | MO
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Zip | 65804-3982
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Country | US
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Telephone | 708-921-8710
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Fax |
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Provider Business Mailing Address
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Address Line | 5156 S WALNUT HILL RD
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City | SPRINGFIELD
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State | MO
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Zip | 65810-2008
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Country | US
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Telephone | 708-921-8710
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | AMANDA SHOUSE
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Credential | EDD
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Telephone | 708-921-8710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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