Organization Name: | FAMILY COUNSELING CENTER |
NPI Number: | 1144674342 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAWN SANDO (CEO) |
Mailing Address: | 925 Highway V V Kennett |
State: | MO US |
Postal Code: | 638570071 |
Phone Number: | 5738885925 |
Fax Number: | 5738889365 |
NPI Enumeration Date: | 04/14/2016 |
NPI Last Update Date: | 04/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |