Organization Name: | PREFERRED FAMILY HEALTHCARE |
NPI Number: | 1043343940 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DORIS SAWYER (CREDENTIALING SPECIALIST) |
Mailing Address: | 1715 S Morley St Moberly |
State: | MO US |
Postal Code: | 652703022 |
Phone Number: | 6602631113 |
Fax Number: | 6602634572 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 12/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 6300-9238 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |