Provider Demographics
NPI:1366746844
Name:THE H.O.U.S.E INC.,
Entity type:Organization
Organization Name:THE H.O.U.S.E INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKELS
Authorized Official - Suffix:
Authorized Official - Credentials:CRADC, CCJP
Authorized Official - Phone:417-623-8933
Mailing Address - Street 1:24730 STATE HIGHWAY 171
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-2413
Mailing Address - Country:US
Mailing Address - Phone:417-623-8933
Mailing Address - Fax:417-623-3223
Practice Address - Street 1:2004 S JOPLIN AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2032
Practice Address - Country:US
Practice Address - Phone:417-540-2958
Practice Address - Fax:417-623-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010036933324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility