| New Vision Youth And Family Services Inc | |
|
112 S Broadview St Cape Girardeau MO 63703-5759 | |
| (573) 334-3486 | |
| (573) 334-3524 |
| Full Name | New Vision Youth And Family Services Inc |
|---|---|
| Speciality | Counselor |
| Location | 112 S Broadview St, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Monica Griffith (OFFICE MANAGER) |
| Authorized Official Contact | 5733343486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Vision Youth And Family Services Inc 112 S Broadview St Cape Girardeau MO 63703-5759 Ph: (573) 334-3486 | New Vision Youth And Family Services Inc 112 S Broadview St Cape Girardeau MO 63703-5759 Ph: (573) 334-3486 |
| NPI Number | 1396950614 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 10/04/2022 |
| Certification Date | 10/04/2022 |
| Medicare PECOS PAC ID | 7911963194 |
|---|---|
| Medicare Enrollment ID | O20041209000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396950614 | NPI | - | NPPES |
| 500285200 | Medicaid | MO |
| Provider Name | Lori Jane Blattner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730485921 PECOS PAC ID: 1850575689 Enrollment ID: I20110401000888 |
| Provider Name | Gail Mateka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346628849 PECOS PAC ID: 5092020982 Enrollment ID: I20150821013098 |
| Provider Name | Kimberly Ann Frank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114684842 PECOS PAC ID: 7517302946 Enrollment ID: I20240226001736 |
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