| Organization Name: | VICTOR'S S CROWN CHRISTIAN COUNSELING CENTER LLC |
| NPI Number: | 1003218819 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLLEEN MURRAY (OWNER) |
| Mailing Address: | 571 Vfw Memorial Dr Saint Robert |
| State: | MO US |
| Postal Code: | 655844841 |
| Phone Number: | 5735282192 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2014 |
| NPI Last Update Date: | 11/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2011013510 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |