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Faith Tabernacle World Outreach Inc
Emotionally Disturbed Childrens' Residential Treatment Facility in Fredericktown, Missouri
NPI 1417070210

Faith Tabernacle World Outreach Inc is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Fredricktown, MO. Faith Tabernacle World Outreach Inc practices in Fredericktown, MO. The NPI Number for Faith Tabernacle World Outreach Inc is 1417070210 and holds a License No. (Missouri).

The current practice location address for Faith Tabernacle World Outreach Inc is 600 Sargent Dr, Fredericktown, MO and can be reached out via phone at 573-783-4400 and via fax at 573-783-4409.

Location: 600 Sargent Dr, Fredericktown, MO, 63645
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1417070210
Provider Name
Faith Tabernacle World Outreach Inc
Credential
Provider Entity Type
Organization
Address
600 Sargent Dr, Fredericktown, MO, 63645
Phone Number
573-783-4400
Fax Number
573-783-4409
Provider Enumeration Date
04/08/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
490026705 05 MO
495888919 05 MO
495933814 05 MO
495968604 05 MO
institution
Provider Business Practice Location Address Details
Address
600 Sargent Dr
City
Fredericktown
State
Missouri
Zip
63645-7526
Phone Number
573-783-4400
Fax Number
573-783-4409
person
Provider Business Mailing Address Details
Address
600 Sargent Dr
City
Fredericktown
State
Missouri
Zip
63645-7526
Phone Number
573-783-4400
Fax Number
573-783-4409
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
001742092 (Missouri)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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