Organization
MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC.
Active
Other names
Mark Twain Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GENE CANTRELL MBA (PRESIDENT & CEO)
(573) 600-9613
Entity
Organization
Contact information
Practice address
154 FORREST DR, HANNIBAL, MO 63401-5511
(573) 221-2120
(573) 221-4380
Mailing address
154 FORREST DR, HANNIBAL, MO 63401-5511
(573) 221-2120
(573) 221-4380
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152473500
—
MO
Enumeration date
01/05/2007
Last updated
01/05/2021
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