DIANA'S BOARDING HOME 2 INC NPI 1285227397

NPI Information

NPI: 1285227397
Provider Name: DIANA'S BOARDING HOME 2 INC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
4677 STATE HWY M
MARBLE HILL, MO
ZIP 63764
Phone: (573) 238-3344
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DIANA'S BOARDING HOME 2 INC is a community based residential treatment facility mental illness in Marble Hill, MO. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. DIANA'S BOARDING HOME 2 INC NPI is 1285227397. The provider is registered as an organization entity type.

The provider's business location address is:

4677 STATE HWY M
MARBLE HILL, MO
ZIP 63764-408
Phone: (573) 238-3344
Fax: (573) 238-3361

The provider's authorized official is Terry Dustin Wagner .
The authorized official title is Owner/president and has the following contact phone number (573) 238-3344.

The enumeration date for this NPI number is 2/19/2021 and was last updated on 2/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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