Provider Demographics
NPI:1215188313
Name:WEST CENTRAL MISSOURI COMMUNITY ACTION AGENCY
Entity Type:Organization
Organization Name:WEST CENTRAL MISSOURI COMMUNITY ACTION AGENCY
Other - Org Name:WOMEN'S HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CHIEF EXECUTIVE OFFIC
Authorized Official - Prefix:MR
Authorized Official - First Name:AMOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-476-2185
Mailing Address - Street 1:106 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64724-0125
Mailing Address - Country:US
Mailing Address - Phone:660-476-2185
Mailing Address - Fax:660-476-9241
Practice Address - Street 1:106 W 4TH ST
Practice Address - Street 2:
Practice Address - City:APPLETON CITY
Practice Address - State:MO
Practice Address - Zip Code:64724-0125
Practice Address - Country:US
Practice Address - Phone:660-476-2185
Practice Address - Fax:660-476-9241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO059306261QA0005X
MOR6098261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility