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1212 Weber St. Farmington MO 63640-3325 | |
| (573) 756-4581 | |
| (573) 756-5834 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1212 Weber St., Farmington, Missouri |
| Authorized Official Name and Position | Neil W. Kunkel (VP & SECRETARY) |
| Authorized Official Contact | 6157643000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1212 Weber St. Farmington MO 63640-3325 Ph: (573) 756-4581 | 1212 Weber St. Farmington MO 63640-3325 Ph: (573) 756-4581 |
| NPI Number | 1629391636 |
|---|---|
| Provider Enumeration Date | 03/04/2010 |
| Last Update Date | 12/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629391636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 509-1 (Missouri) | Secondary |
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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