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Organization

FAIR HAVEN CHILDREN'S HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BARNEY CRAWFORD (ADMINISTRATOR)
(417) 862-6675
Entity
Organization

Contact information

Practice address
3132 N FAIR HAVEN LOOP, STRAFFORD, MO 65757-8619
(417) 882-4485
Mailing address
3132 N FAIR HAVEN LOOP, STRAFFORD, MO 65757-8619

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MO

Other

Enumeration date
11/09/2010
Last updated
11/29/2010
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