MEDICARE: INTERLINK BEHAVIORAL SERVICES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	R8N52	MO

General Provider Information

NPI Number	:	1134302656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERLINK BEHAVIORAL SERVICES, P.C.

Provider Business Mailing Address
First Line	:	3121 S TERRACE GREEN CT
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-4555
Country	:	US
Telephone Number	:	417-860-3708
Fax Number	:

Provider Business Practice Location Address
First Line	:	3121 S TERRACE GREEN CT
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-4555
Country	:	US
Telephone Number	:	417-860-3708
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY JENKINS
Credential	:	M.D.
Telephone Number	:	417-860-3708

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/06/2007

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