Boys & Girls Town of Missouri

Organization Active NPI Psychiatric Residential Treatment Facility · Springfield, MO

NPI 1295801678 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1295801678
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric Residential Treatment Facility 323P00000X
License
002691 (MO)
Legal business name
BOYS & GIRLS TOWN OF MISSOURI
Practice address
1212 W Lombard St
Springfield, MO 65806-2720
Phone
(417) 865-1646
NPI assigned
Nov 28, 2006
Organization subpart
No

Authorized official

Name
Ms. Marla H. Underwood, MS, LPC, NCC
Title
Therapist
Phone
(417) 865-1646

Corporate family (same tax ID) 13

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

National Provider Directory

Tax ID family
Great Circle (14 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 002691 MO Yes

Addresses

Primary practice location

1212 W Lombard St
Springfield, MO 65806-2720

Mailing address

426 N Alexander Ave
Republic, MO 65738-1235
Phone (417) 732-2416

Other providers in Springfield, MO

All providers in Springfield, MO · Psychiatric Residential Treatment Facility in Missouri

Sources for this page

Verify at the official NPI Registry.