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General NPI Number Information
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NPI Number | 1902158413
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Entity Type | Organization
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Legal Business Name | A HORIZON OF HOPE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 764 WEBER RD
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City | FARMINGTON
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State | MO
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Zip | 63640-3317
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Country | US
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Telephone | 573-756-1969
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 173
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City | FARMINGTON
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State | MO
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Zip | 63640-0173
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | TERRI LYNN PATTERSON
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Credential | LPC, CCJP,MS, MARS
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Telephone | 573-218-4405
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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 | 4937
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License Number State | MO
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