Organization
HUMBLE HEARTS CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI KAY GROSS (OWNER OPERATOR OF HUMBLE HEARTS CAR)
(417) 664-3838
Entity
Organization
Contact information
Practice address
652 STATE RD M, CONWAY, MO 65632
(417) 664-3838
Mailing address
652 STATE RD M, CONWAY, MO 65632
(417) 664-3838
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8001865
DMH DEPT OF MENTAL HEALTH
MO
01
—
EROM0638
DEPT OF MENTAL HEALTH
MO
Enumeration date
03/26/2007
Last updated
08/22/2020
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