Organization
OZARKS MEDICAL CENTER
Active
Other names
Ozarks Medical Center, OMC YOUTH CPRC
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KELLER (PRESIDENT)
(417) 257-9111
Entity
Organization
Contact information
Practice address
1211 PORTER WAGONER BLVD # 23, WEST PLAINS, MO 65775-1826
(417) 257-6762
(417) 257-5875
Mailing address
PO BOX 1100, WEST PLAINS, MO 65775-1100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
174-48
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876175613
—
MO
Enumeration date
05/15/2007
Last updated
07/17/2024
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