| Changing Tides Behavioral Health, Llc | |
|
2606 N Bluff St Ste 102a Fulton MO 65251-7257 | |
| (573) 220-6420 | |
| (573) 592-0107 |
| Full Name | Changing Tides Behavioral Health, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2606 N Bluff St Ste 102a, Fulton, Missouri |
| Authorized Official Name and Position | Jennifer Hrebar-ihler (OWNER/PROVIDER) |
| Authorized Official Contact | 5735736420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Tides Behavioral Health, Llc 3133 County Road 223 Kingdom City MO 65262-1905 Ph: (573) 220-6420 | Changing Tides Behavioral Health, Llc 2606 N Bluff St Ste 102a Fulton MO 65251-7257 Ph: (573) 220-6420 |
| NPI Number | 1437747615 |
|---|---|
| Provider Enumeration Date | 01/04/2021 |
| Last Update Date | 02/18/2021 |
| Certification Date | 02/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437747615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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