Provider Demographics
NPI:1851534523
Name:TENDER HEARTS CHILD THERAPY CENTER
Entity Type:Organization
Organization Name:TENDER HEARTS CHILD THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOHIMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:573-204-8901
Mailing Address - Street 1:3191 OLD CAPE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-3725
Mailing Address - Country:US
Mailing Address - Phone:573-204-8901
Mailing Address - Fax:573-204-8902
Practice Address - Street 1:3191 OLD CAPE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-3725
Practice Address - Country:US
Practice Address - Phone:573-204-8901
Practice Address - Fax:573-204-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW004672101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty