Organization
CHAMP CLARK SERVICE COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY RENEE MACLAUGHLIN (EXECUTIVE DIRECTOR)
(573) 324-6226
Entity
Organization
Contact information
Practice address
912 HIGHWAY 161, BOWLING GREEN, MO 63334-2433
(573) 324-6226
Mailing address
912 HIGHWAY 161, BOWLING GREEN, MO 63334-2433
(573) 324-6226
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/17/2017
Last updated
04/03/2017
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