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320 N Lincoln St East Prairie MO 63845-1160 | |
(573) 649-3026 | |
(573) 471-0461 |
Full Name | |
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Speciality | Clinic/Center |
Location | 320 N Lincoln St, East Prairie, Missouri |
Authorized Official Name and Position | Justin Davison (CFO) |
Authorized Official Contact | 5733313000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 801143 Kansas City MO 64180-1143 Ph: (573) 331-3000 | 320 N Lincoln St East Prairie MO 63845-1160 Ph: (573) 649-3026 |
NPI Number | 1952878704 |
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Provider Enumeration Date | 10/30/2018 |
Last Update Date | 07/28/2021 |
Certification Date | 07/27/2021 |
Medicare PECOS PAC ID | 9931007929 |
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Medicare Enrollment ID | O20190517001371 |
Identifier | Type | State | Issuer |
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1952878704 | NPI | - | NPPES |
Quality Care Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 E Main St, East Prairie, MO 63845 Phone: 573-649-9082 Fax: 573-649-9626 |