Organization
ESCAPE A&D, LLC
Active
Other names
ESCAPE Outpatient Chemical Dependency Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY SCOTT EAMES MS MAC CASAC CCCJS (CEO PRIMARY THERAPIST)
(660) 263-7552
Entity
Organization
Contact information
Practice address
501 N AULT ST, MOBERLY, MO 65270-2506
(660) 263-7552
(660) 263-6593
Mailing address
501 N AULT ST, MOBERLY, MO 65270-2506
(660) 263-7552
(660) 263-6593
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
1253-10266
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1253-10266
MO STATE CERTIFIED INTENMSIVE OUTPATIENT ALCOHOL & DRUG REHABILITATION CLINIC
MO
01
—
CASAC 542
MISSOURI SUBSTANCE ABUSE PROFESSIONAL CREDENTIALING BOARD
MO
01
—
CCCJS A11182
AMERICAN COLLEGE OF CERTIFIED FORENSIC COUNSELORS
—
01
—
ICAADC 597
THE INTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM / A & D ABUSE, INC.
—
01
—
MAC 501662
NATIONAL ASSOCIATION OF ALCOHOL & DRUG ABUSE COUNSELORS
—
01
—
REACT R-319
MO STATE CERTIFIED REQUIRED EDUCATIONAL ASSESSMENT AND COMMUNITY TREATMENT
MO
01
—
SATOP 066
MO STATE CERTIFIED SUBSTANCE ABUSE TRAFFIC OFFENDER PROGRAMS
MO
01
—
VENDOR 000613401
MISSOURI DEPARTMENT OF SOCIAL SERVICES, CHILDRENS DIVISION
MO
Enumeration date
04/23/2008
Last updated
04/23/2008
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