Provider Demographics
NPI:1942337662
Name:GREEN HILLS RURAL DEVELOPMENT, INC, DBA NORTH CENTRAL MISSOURI ADVOCAC
Entity type:Organization
Organization Name:GREEN HILLS RURAL DEVELOPMENT, INC, DBA NORTH CENTRAL MISSOURI ADVOCAC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KELSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-359-2874
Mailing Address - Street 1:703 MAIN
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683
Mailing Address - Country:US
Mailing Address - Phone:660-359-2874
Mailing Address - Fax:660-359-2837
Practice Address - Street 1:703 MAIN
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683
Practice Address - Country:US
Practice Address - Phone:660-359-2874
Practice Address - Fax:660-359-2837
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREEN HILLS RURAL DEVELOPMENT, INC, DBA NORTH CENTRAL MISSOURI ADVOCAC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-28
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty