Organization
FAMILY COUNSELING CENTER OF MISSOURI INC
Active
Other names
Cedar Ridge Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN TACKER PH.D. (EXECUTIVE DIRECTOR)
(573) 443-2204
Entity
Organization
Contact information
Practice address
1091 MIDWAY DR, LINN CREEK, MO 65052-1687
(573) 346-6758
(573) 346-0621
Mailing address
117 N GARTH AVE, COLUMBIA, MO 65203-4103
(573) 443-2204
(573) 875-6607
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649269622
FCCMO BILLING NPI NUMBER
MO
Enumeration date
02/21/2007
Last updated
08/22/2020
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