Organization
UNBOUND HORIZON OUTPATIENT SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASEFA GEBRE PHYSICIAN ASSISTANT (OWNER)
(417) 540-4915
Entity
Organization
Contact information
Practice address
2929 S GRAND AVE, CARTHAGE, MO 64836-7803
(417) 540-4915
Mailing address
2929 S GRAND AVE, CARTHAGE, MO 64836-7803
(417) 540-4915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/19/2026
Last updated
05/15/2026
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