Provider Demographics
NPI:1235391178
Name:THE CURATORS OF THE UNIVERSITY OF MISSOURI ON BEHALF OF THE THOMPSON C
Entity Type:Organization
Organization Name:THE CURATORS OF THE UNIVERSITY OF MISSOURI ON BEHALF OF THE THOMPSON C
Other - Org Name:THOMPSON CENTER FOR AUTISM AND NEURODEVELOPMENTAL DISORDERS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:POEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-884-6196
Mailing Address - Street 1:300 PORTLAND ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65211-0001
Mailing Address - Country:US
Mailing Address - Phone:573-882-6081
Mailing Address - Fax:
Practice Address - Street 1:300 PORTLAND ST
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65211-0001
Practice Address - Country:US
Practice Address - Phone:573-882-6081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001186261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty