Organization
BOYS AND GIRLS TOWN MISSOURI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG SHANK MSW, (THERAPIST)
(417) 865-1646
Entity
Organization
Contact information
Practice address
1212 W LOMBARD ST, SPRINGFIELD, MO 65806-2720
(417) 865-1646
(417) 866-1483
Mailing address
412 CARDINAL CT, NIXA, MO 65714-8848
(417) 725-8684
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
2002002751
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494901309
—
MO
Enumeration date
11/07/2006
Last updated
10/23/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us