NPIMap

Organization Active NPI

Mark Twain Association for Mental Health, Inc

Doing business as Mark Twain Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hannibal, MO
National Provider Identifier
1710656509
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC
Doing business as
Mark Twain Behavioral Health
Practice address
146 Communication Dr
Hannibal, MO 63401-3672
Phone
(573) 248-1196
NPI assigned
Sep 7, 2021
Last updated
Sep 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Authorized official

Name
Jenny Sue Haught, MBA
Title
Vice President of Finance
Phone
(573) 600-9616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

146 Communication Dr
Hannibal, MO 63401-3672

Mailing address

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

Other practice location 1

3125 Palmyra Rd
Hannibal, MO 63401-2203
Phone (573) 248-1196

Other identifiers 1

IdentifierTypeStateIssuer
860006402MedicaidMO

Other names 1

  • Mark Twain Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mark Twain Area Counsel10 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.

Locations

3125 Palmyra Rd
Hannibal, MO 63401
Phone (573) 248-1196

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1710656509",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 COMMUNICATION DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013672",
            "telephone_number": "573-248-1196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Palmyra Rd",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634012203",
            "country_code": "US",
            "telephone_number": "573-248-1196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARK TWAIN ASSOCIATION FOR MENTAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "HAUGHT",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "573-600-9616",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "860006402",
            "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 Sep 7, 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.