Organization
OWL ADVENTURES LLC
Active
Organization
OWL ADVENTURES LLC
Active
Other names
BOOTHEEL OUTPATIENT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
LARA HUFFMAN M.D. (CEO)
(573) 922-7383
Entity
Organization
Contact information
Practice address
215 S 3RD ST, HAYTI, MO 63851-1617
(573) 922-7383
Mailing address
215 S 3RD ST, HAYTI, MO 63851-1617
(573) 922-7383
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/23/2019
Last updated
01/16/2020
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