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1101 W Liberty St Senior Support Center Farmington MO 63640-1921 | |
| (573) 756-6451 | |
| (573) 756-1408 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1101 W Liberty St, Farmington, Missouri |
| Authorized Official Name and Position | Annette Schnabel (PRESIDENT) |
| Authorized Official Contact | 5737608280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1101 W Liberty St Farmington MO 63640-1921 Ph: (573) 756-6451 | 1101 W Liberty St Senior Support Center Farmington MO 63640-1921 Ph: (573) 756-6451 |
| NPI Number | 1902814866 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 07/21/2022 |
| Certification Date | 03/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902814866 | NPI | - | NPPES |
| 010638203 | Medicaid | MO | |
| 119 | Other | BLUE CROSS-BLUE SHIELD | |
| 856X8562 | Other | HEALTHCARE USA | |
| 182901 | Other | HEALTH LINK | |
| 260163 | Other | MERCY | |
| 260163 | Other | MERCY MC | |
| 5020035 | Other | UNITED HEALTH CARE | |
| 999681 | Other | COMMUNITY CARE PLUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 379-13 (Missouri) | Primary |
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