Organization
RESIDENTIAL PSYCHIATRIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONA KAY EVANS MSW, LCSW (PRESIDENT)
(573) 783-4292
Entity
Organization
Contact information
Practice address
1269 DOCTORS DR, FARMINGTON, MO 63640-2947
(573) 664-1146
(573) 664-1149
Mailing address
1269 DOCTORS DR, FARMINGTON, MO 63640-2947
(573) 664-1146
(573) 664-1149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002060
MO
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500830906
—
MO
01
—
850830902
DMH
MO
Enumeration date
08/09/2005
Last updated
08/29/2016
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