Organization
ELEVATED CARE MO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WARDLOW JR. LPC, CCDP-D, MARS (CEO)
(573) 664-1326
Entity
Organization
Contact information
Practice address
764 WEBER RD, FARMINGTON, MO 63640-3317
(573) 664-1326
(573) 664-1328
Mailing address
764 WEBER RD, FARMINGTON, MO 63640-3317
(573) 664-1326
(573) 664-1328
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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