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Organization
MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC.
Active
Organization
MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC.
Active
Other names
Mark Twain Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GENE CANTRELL MBA (PRESIDENT & CEO)
(573) 600-9613
Entity
Organization
Contact information
Practice address
154 FORREST DR, HANNIBAL, MO 63401-5511
(573) 221-2120
(573) 221-4380
Mailing address
154 FORREST DR, HANNIBAL, MO 63401-5511
(573) 221-2120
(573) 221-4380
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876173113
—
MO
Enumeration date
01/04/2007
Last updated
01/05/2021
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