Provider Demographics
NPI:1598931537
Name:SIGMA HOUSE OF SPRINGFIELD, INC.
Entity Type:Organization
Organization Name:SIGMA HOUSE OF SPRINGFIELD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CASAC
Authorized Official - Phone:417-862-3339
Mailing Address - Street 1:800 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-4855
Mailing Address - Country:US
Mailing Address - Phone:417-862-3339
Mailing Address - Fax:417-862-3362
Practice Address - Street 1:800 S PARK AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4855
Practice Address - Country:US
Practice Address - Phone:417-862-3339
Practice Address - Fax:417-862-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility