Organization
MICHAEL W. PRENGER FAMILY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D COUTY (COURT ADMINISTRATOR)
(573) 636-5177
Entity
Organization
Contact information
Practice address
400 STADIUM BLVD, JEFFERSON CITY, MO 65101-2811
(573) 636-5177
(573) 634-5162
Mailing address
400 STADIUM BLVD, JEFFERSON CITY, MO 65101-2811
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/13/2009
Last updated
01/13/2009
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