Organization
HUMBLE HEARTS CARE SERVICE
Active
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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