| Organization Name: | DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. |
| NPI Number: | 1972812592 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER HEINLEIN (HR) |
| Mailing Address: | 603 Nw 10th Ave. Ava |
| State: | MO US |
| Postal Code: | 65608 |
| Phone Number: | 4176835739 |
| Fax Number: | 4176831602 |
| NPI Enumeration Date: | 09/30/2010 |
| NPI Last Update Date: | 09/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 1999135384 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |