Organization
ARCHIE R-V
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE HARMON (DIRECTOR SPEC. PROG.)
(816) 293-5312
Entity
Organization
Contact information
Practice address
302 WEST STATE ROUTE A, ARCHIE, MO 64725-0106
(816) 293-5312
(816) 293-5712
Mailing address
PO BOX 106, 302 WEST STATE ROUTE A, ARCHIE, MO 64725-0106
(816) 293-5312
(816) 293-5712
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506073600
—
MO
Enumeration date
02/07/2007
Last updated
05/15/2014
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