Organization · Type 2 NPI
Southern Light Residential
Professional Counselor · Bolivar, MO
NPI number
1801312459
Active
Practice location
1211 E Broadway St
Bolivar, MO 65613-2952
Fax (417) 777-7017
Mailing address
707 S Pearl Ave
Joplin, MO 64801-4334
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
4 other providers at this address
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- Home Court Advantage, Inc.Psychiatric Residential Treatment Facility Bolivar, MO NPI 1164646162
- Home Court Advantage, Inc.Psychiatric Residential Treatment Facility Bolivar, MO NPI 1346464344
Other professional counselor providers in Bolivar
About NPI 1801312459
Southern Light Residential's National Provider Identifier is 1801312459, issued on Aug 16, 2017. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bolivar, MO. The record was last updated on Aug 16, 2017.