Berley Beck
Individual provider Active NPI Children's Substance Abuse Rehabilitation Facility · Kennett, MO
NPI 1649653221 · NPPES record last updated Jul 1, 2015
Key facts
- NPI
- 1649653221
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Children's Substance Abuse Rehabilitation Facility 3245S0500X
- Practice address
- 1109 Jones St
Kennett, MO 63857-3824 - Phone
- (573) 888-6545
- NPI assigned
- Jul 1, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | Yes |
Addresses
Primary practice location
1109 Jones St
Kennett, MO 63857-3824
Mailing address
1109 Jones St
Kennett, MO 63857-3824
Other providers in Kennett, MO
- Joseph Earl Bates
- Kayla Bates
- Krista K Bates
- Tyler A Battles
- Tracey Beaver
- Jeffrey Tyler Beck
- Melinda Gaye Becknell
- Erin Jon Bedwell
- Christina L Bellers
- Evy Jo Benjamin
All providers in Kennett, MO · Children's Substance Abuse Rehabilitation Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.