Faith Foundation Children'S Home

LBN: Faith Tabernacle World Outreach Inc
Faith Foundation Children'S Home is an health care organization with primary practice located at 600 Sargent Dr , Fredericktown MO 63645-7526. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children. Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children is the primary health care specialty. Faith Tabernacle World Outreach Inc can be contacted via phone (573) 783-4400, or through Booth, Deborah Joy via phone (573) 783-4400.

Contact Information

Primary practice address
600 Sargent Dr Fredericktown MO 63645-7526
Phone: (573) 783-4400
Fax: (573) 783-4409
Website:
Map and Directions
Authorized official contact:
Name: Booth, Deborah Joy Licensed Professional Counselor (LPC)
Phone: (573) 783-4400

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X 001742092 Missouri

Profile Details

NPI number 1417070210
LBN Legal business name Faith Tabernacle World Outreach Inc
DBA Doing business as Faith Foundation Children'S Home
Authorized official Booth, Deborah Joy Licensed Professional Counselor (LPC)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 8th, 2007
Last updated Jul 6th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417070210 NPPES
Missouri MEDICAID 490026705
Missouri MEDICAID 495888919
Missouri MEDICAID 495933814
Missouri MEDICAID 495968604

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