Organization
GREAT CIRCLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN RENEE KLIETHERMES (CREDENTIALING SPECIALIST)
(573) 303-7219
Entity
Organization
Contact information
Practice address
13160 COUNTY ROAD 3610, SAINT JAMES, MO 65559-0189
(573) 265-3251
(573) 265-8571
Mailing address
PO BOX 189, SAINT JAMES, MO 65559-0189
(573) 265-3251
(573) 265-8571
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
430681470A
MO
253J00000X
Foster Care Agency
000046739
MO
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
0A
MO
323P00000X
Psychiatric Residential Treatment Facility
000045712
MO
323P00000X
Psychiatric Residential Treatment Facility
000045767
MO
323P00000X
Psychiatric Residential Treatment Facility
Primary
000046739
MO
323P00000X
Psychiatric Residential Treatment Facility
0000469461
MO
323P00000X
Psychiatric Residential Treatment Facility
000363075
MO
323P00000X
Psychiatric Residential Treatment Facility
001943115
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507009603
—
MO
Enumeration date
11/02/2006
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us