# FAITH TABERNACLE WORLD OUTREACH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Faith Foundation Children's Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417070210
- **Authorized official:** MRS. DEBORAH JOY BOOTH LPC (CLINICAL DIRECTOR)
- **Authorized official phone:** (573) 783-4400

## Contact information

- **Practice address:** 600 SARGENT DR, FREDERICKTOWN, MO 63645-7526
- **Practice address phone:** (573) 783-4400
- **Practice address fax:** (573) 783-4409
- **Mailing address:** PO BOX 25, FREDRICKTOWN, MO 63645
- **Mailing address phone:** (573) 783-4400
- **Mailing address fax:** (573) 783-4409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 001742092 | MO | Yes |

## Other

- **Enumeration date:** 04/08/2007
- **Last updated:** 10/15/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 490026705 | — | MO |
| 05 | — | 495888919 | — | MO |
| 05 | — | 495933814 | — | MO |
| 05 | — | 495968604 | — | MO |