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Organization
FOSTERING COMMUNITIES
Active
Organization
FOSTERING COMMUNITIES
Active
Other names
Community Works
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENER ESTRADA GARCIA MS, LPC (CEO, CHIEF EXECUTIVE OFFICER)
(417) 658-5409
Entity
Organization
Contact information
Practice address
836 S SUBURBAN AVE, SPRINGFIELD, MO 65802-6774
(417) 658-5409
Mailing address
3871 S SUBURBAN, SPRINGFIELD, MO 65807
(417) 658-5408
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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