Provider Demographics
NPI:1679205520
Name:SECOND JUDICIAL CIRCUIT OF MISSOURI DBA BNJJC
Entity Type:Organization
Organization Name:SECOND JUDICIAL CIRCUIT OF MISSOURI DBA BNJJC
Other - Org Name:BRUCE NORMILE JUVENILE JUSTICE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COURT SERVICES ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:660-665-4224
Mailing Address - Street 1:1400 S BOUNDARY ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-1704
Mailing Address - Country:US
Mailing Address - Phone:660-665-4224
Mailing Address - Fax:
Practice Address - Street 1:1400 S BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-1704
Practice Address - Country:US
Practice Address - Phone:660-665-4224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children