NPIMap

Organization Active NPI

Mark Twain Association for Mental Health, Inc.

  • Adult Mental Health Clinic/Center
  • Hannibal, MO
National Provider Identifier
1184771149
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC.
Doing business as
Mark Twain Behavioral Health
Practice address
154 Forrest Dr
Hannibal, MO 63401-5511
Phone
(573) 221-2120
Fax
(573) 221-4380
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael Gene Cantrell, MBA
Title
President & Ceo
Phone
(573) 600-9613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

154 Forrest Dr
Hannibal, MO 63401-5511

Mailing address

154 Forrest Dr
Hannibal, MO 63401-5511
Phone (573) 221-2120

Other identifiers 1

IdentifierTypeStateIssuer
876173105MedicaidMO

Other names 1

  • Mark Twain Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mark Twain Assoc Health Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1184771149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 FORREST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634015511",
            "telephone_number": "573-221-2120",
            "fax_number": "573-221-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 FORREST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634015511",
            "telephone_number": "573-221-2120",
            "fax_number": "573-221-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "573-600-9613",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876173105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark Twain Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.