MEDICARE: OZARK BEHAVIORAL HEALTH, LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1811631989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZARK BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	2725 N WESTWOOD BLVD
Second Line	:
City	:	POPLAR BLUFF
State	:	MO
Zip	:	63901-2388
Country	:	US
Telephone Number	:	573-872-4175
Fax Number	:	573-686-6846

Provider Business Practice Location Address
First Line	:	2725 N WESTWOOD BLVD STE 14
Second Line	:
City	:	POPLAR BLUFF
State	:	MO
Zip	:	63901-2367
Country	:	US
Telephone Number	:	573-686-5510
Fax Number	:	573-300-4914

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. CHRISTINA ELAINE BLURTON
Credential	:
Telephone Number	:	573-872-4175

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	05/27/2026

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