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NPI Code Detail

MEDICARE: SIGMA HOUSE OF SPRINGFIELD, INC.

MEDICARE: SIGMA HOUSE OF SPRINGFIELD, INC.
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1598931537
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIGMA HOUSE OF SPRINGFIELD, INC.
Provider Business Mailing Address
First Line : 800 S PARK AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65802-4855
Country : US
Telephone Number : 417-862-3339
Fax Number : 417-862-3362
Provider Business Practice Location Address
First Line : 800 S PARK AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65802-4855
Country : US
Telephone Number : 417-862-3339
Fax Number : 417-862-3362
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. FRANK ALLEN TINNEY
Credential : MSW, CASAC
Telephone Number : 417-862-3339
Provider Enumeration Date : 04/30/2008
Last Update Date : 04/30/2008

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