Basic Information
| Provider Information | |||||||||
| NPI: | 1215676457 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOCIAL WELFARE BOARD OF THE COUNTY OF BUCHANAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 904 S 10TH ST STE A | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645032400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162335188 | ||||||||
| FaxNumber: | 8162335296 | ||||||||
| Practice Location | |||||||||
| Address1: | 904 S 10TH ST STE A | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645032400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162335188 | ||||||||
| FaxNumber: | 8162335296 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2022 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | JUDAH | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | CARMEL | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8162335188 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN,MSN | ||||||||
| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP0905X | Y | Ambulatory Health Care Facilities | Clinic/Center | Public Health, State or Local |
No ID Information.