Organization
FAITH TABERNACLE WORLD OUTREACH INC
Active
Other names
Faith Foundation Children's Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH JOY BOOTH LPC (CLINICAL DIRECTOR)
(573) 783-4400
Entity
Organization
Contact information
Practice address
600 SARGENT DR, FREDERICKTOWN, MO 63645-7526
(573) 783-4400
(573) 783-4409
Mailing address
PO BOX 25, FREDRICKTOWN, MO 63645
(573) 783-4400
(573) 783-4409
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
001742092
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490026705
—
MO
05
—
495888919
—
MO
05
—
495933814
—
MO
05
—
495968604
—
MO
Enumeration date
04/08/2007
Last updated
10/15/2025
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