Organization · Type 2 NPI

Faith Tabernacle World Outreach Inc

Emotionally Disturbed Childrens' Residential Treatment Facility · Fredericktown, MO

NPI number 1417070210 Active

Practice location

600 Sargent Dr
Fredericktown, MO 63645-7526

Call (573) 783-4400 Map

Fax (573) 783-4409

Mailing address

PO Box 25
Fredricktown, MO 63645

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	001742092 (MO)

Emotionally Disturbed Childrens' Residential Treatment Facility: 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.

5 other providers at this address

NPI record

NPI: 1417070210
Entity type: Organization (Type 2)
Issued: Apr 8, 2007
Last updated: Oct 15, 2025
Status: Active

Other names

<unavail>
Faith Foundation Children's Home · doing business as
Faith Foundation Children's Home · doing business as

Authorized official

Mrs. Deborah Joy Booth, LPC
Clinical Director
(573) 783-4400

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About NPI 1417070210

Faith Tabernacle World Outreach Inc's National Provider Identifier is 1417070210, issued on Apr 8, 2007. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Fredericktown, MO. The record was last updated on Oct 15, 2025.