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General NPI Number Information
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NPI Number | 1982984365
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Entity Type | Organization
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Legal Business Name | REALITY HOUSE, INC.
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 1900 E PRATHERSVILLE RD
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City | COLUMBIA
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State | MO
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Zip | 65202-9260
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Country | US
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Telephone | 573-449-8117
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Fax | 573-874-1225
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | COLUMBIA
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State | MO
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Zip | 65205-1507
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Country | US
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Telephone | 573-449-8117
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Fax | 573-874-1225
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DENNIS J WINFREY
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Credential | LPC
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Telephone | 573-449-8117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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