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Organization

FAMILY INSTITUTE OF MENTAL HEALTH, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BETSY HACKER WAHL L.P.C. (PRESIDENT/THERAPIST)
(417) 588-2933
Entity
Organization

Contact information

Practice address
281 S JEFFERSON AVE, SUITE J, LEBANON, MO 65536-3226
(417) 588-2933
Mailing address
23175 PARADISE DR, LEBANON, MO 65536-5146
(417) 588-2933

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
000080
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508837857
MO
Enumeration date
06/30/2008
Last updated
06/30/2008
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