NPIMap

Organization Active NPI

Farmington Missouri Hospital Company LLC

Doing business as Children's Haven

  • Adolescent and Children Mental Health Clinic/Center
  • Farmington, MO
National Provider Identifier
1316989114
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
FARMINGTON MISSOURI HOSPITAL COMPANY LLC
Doing business as
Children's Haven
Practice address
605 Wallace Rd
Farmington, MO 63640-9217
Phone
(573) 756-2108
Fax
(573) 756-1865
NPI assigned
Jun 13, 2006
Organization subpart
Yes
Parent organization
FARMINGTON MISSOURI HOSPITAL COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Debbie T Brewer
Title
Sr Vice President
Phone
(877) 892-9813

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

605 Wallace Rd
Farmington, MO 63640-9217

Mailing address

605 Wallace Rd
Farmington, MO 63640-9217
Phone (573) 756-2108

Other names 1

  • Children's Haven Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Farmington Missouri Hospital Company LLC2 organizations share this tax ID, including this one
Part of
Farmington Missouri Hospital Company LLC

Other organizations with this tax ID 1

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

Locations

605 Wallace Rd
Farmington, MO 63640
Phone (573) 756-2108

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1316989114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 WALLACE RD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636409217",
            "telephone_number": "573-756-2108",
            "fax_number": "573-756-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WALLACE RD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636409217",
            "telephone_number": "573-756-2108",
            "fax_number": "573-756-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGTON MISSOURI HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FARMINGTON MISSOURI HOSPITAL COMPANY LLC",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.