NPI 1013086842

Boys and Girls Town Missouri

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Springfield, MO

Practice location

Address: 1212 W Lombard St, Springfield, MO 65806-2720
Phone: (417) 865-1646
Fax: (417) 866-1483
Mailing address: 412 Cardinal CT, Nixa, MO 65714-8848

Authorised official

Name: Greg Shank
Title: Therapist
Phone: (417) 865-1646

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 2002002751 (MO)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Missouri →

Registry record

NPI: 1013086842
Entity type: Organization
NPI issued: 7 Nov 2006
Record last updated: 23 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.