| Faith Foundation Children's Home | |
|
600 Sargent Dr Fredericktown MO 63645-7526 | |
| (573) 783-4400 | |
| (573) 783-4409 |
| Full Name | Faith Foundation Children's Home |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 600 Sargent Dr, Fredericktown, Missouri |
| Authorized Official Name and Position | Deborah Joy Booth (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5737834400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Foundation Children's Home Po Box 25 Fredricktown MO 63645 Ph: (573) 783-4400 | Faith Foundation Children's Home 600 Sargent Dr Fredericktown MO 63645-7526 Ph: (573) 783-4400 |
| NPI Number | 1417070210 |
|---|---|
| Provider Enumeration Date | 04/08/2007 |
| Last Update Date | 07/06/2022 |
| Certification Date | 06/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417070210 | NPI | - | NPPES |
| 490026705 | Medicaid | MO | |
| 495888919 | Medicaid | MO | |
| 495933814 | Medicaid | MO | |
| 495968604 | Medicaid | MO |
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