Organization
CLARK COMMUNITY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESS MARIE GENEL (BILLING SPECIALIST)
(417) 476-1034
Entity
Organization
Contact information
Practice address
1701 N CENTRAL, MONETT, MO 65708
(417) 476-1034
(417) 476-1082
Mailing address
PO BOX 100, PIERCE CITY, MO 65723-2100
(417) 476-1034
(417) 476-1082
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801807771
—
MO
Enumeration date
05/03/2016
Last updated
05/03/2016
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