Organization
CAPITAL REGION MEDICAL CENTER
Active
Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Center for Mental Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R MCMILLAN (VP-FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
1432 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109-2444
(573) 632-5560
(573) 632-5875
Mailing address
PO BOX 1128, JEFFERSON CITY, MO 65102-1128
(573) 632-5560
(573) 632-5875
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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