Organization
OZARK TRAILS YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS MANTELL (CFO)
(434) 882-2303
Entity
Organization
Contact information
Practice address
40840 CR RD 181-280, WILLOW SPRINGS, MO 65793-6579
(417) 372-2041
Mailing address
1405 DOCTORS DR, WEST PLAINS, MO 65775-4754
(417) 256-4111
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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