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141 Communication Dr Hannibal MO 63401-3670 | |
| (537) 795-7342 | |
| (573) 248-3080 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 141 Communication Dr, Hannibal, Missouri |
| Authorized Official Name and Position | Mark Conover (CHIEF REVENUE OFFICER) |
| Authorized Official Contact | 5736031460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1601 Old South River Rd Saint Charles MO 63303-4120 Ph: (636) 224-1210 | 141 Communication Dr Hannibal MO 63401-3670 Ph: (537) 795-7342 |
| NPI Number | 1023434479 |
|---|---|
| Provider Enumeration Date | 03/10/2014 |
| Last Update Date | 06/07/2022 |
| Certification Date | 06/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023434479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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