Organization
BREAKING THE MENTAL CHAINS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED MELTON LPC (EXECUTIVE DIRECTOR)
(417) 894-2731
Entity
Organization
Contact information
Practice address
1522 E CAMINO ALTO ST, SPRINGFIELD, MO 65804-7303
(417) 894-2731
(417) 890-7757
Mailing address
PO BOX 14462, SPRINGFIELD, MO 65814-0462
(417) 894-2731
(417) 890-7757
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LC1083359
MO
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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