Escape a&D, LLC

Organization Active NPI Public Health or Welfare Agency · Moberly, MO

NPI 1235304098 · NPPES record last updated Apr 23, 2008

Key facts

NPI
1235304098
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
License
1253-10266 (MO)
Legal business name
ESCAPE A&D, LLC
Practice address
501 N Ault St
Moberly, MO 65270-2506
Phone
(660) 263-7552
Fax
(660) 263-6593
NPI assigned
Apr 23, 2008
Organization subpart
No

Authorized official

Name
Mr. Jerry Scott Eames, MS MAC CASAC CCCJS
Title
Ceo Primary Therapist
Phone
(660) 263-7552

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

501 N Ault St
Moberly, MO 65270
Phone (660) 263-7552

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 1253-10266 MO Yes

Addresses

Primary practice location

501 N Ault St
Moberly, MO 65270-2506

Mailing address

501 N Ault St
Moberly, MO 65270-2506
Phone (660) 263-7552

Other identifiers

IdentifierTypeStateIssuer
SATOP 066OtherMOMO STATE CERTIFIED SUBSTANCE ABUSE TRAFFIC OFFENDER PROGRAMS
MAC 501662OtherNATIONAL ASSOCIATION OF ALCOHOL & DRUG ABUSE COUNSELORS
VENDOR 000613401OtherMOMISSOURI DEPARTMENT OF SOCIAL SERVICES, CHILDRENS DIVISION
CCCJS A11182OtherAMERICAN COLLEGE OF CERTIFIED FORENSIC COUNSELORS
ICAADC 597OtherTHE INTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM / A & D ABUSE, INC.
1253-10266OtherMOMO STATE CERTIFIED INTENMSIVE OUTPATIENT ALCOHOL & DRUG REHABILITATION CLINIC
REACT R-319OtherMOMO STATE CERTIFIED REQUIRED EDUCATIONAL ASSESSMENT AND COMMUNITY TREATMENT
CASAC 542OtherMOMISSOURI SUBSTANCE ABUSE PROFESSIONAL CREDENTIALING BOARD

Other names

  • ESCAPE Outpatient Chemical Dependency Counseling Center Former legal business name

Other providers in Moberly, MO

All providers in Moberly, MO · Public Health or Welfare Agency in Missouri

Sources for this page

Verify at the official NPI Registry.