Provider Demographics
NPI:1255914669
Name:LUTHERAN FAMILY AND CHILDREN'S SERVICES
Entity type:Organization
Organization Name:LUTHERAN FAMILY AND CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MOLLIE-BETH
Authorized Official - Middle Name:BACHMANN
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-846-7739
Mailing Address - Street 1:1000 ELLIOT CT
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1144
Mailing Address - Country:US
Mailing Address - Phone:573-846-7739
Mailing Address - Fax:
Practice Address - Street 1:3178 BLATTNER DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6348
Practice Address - Country:US
Practice Address - Phone:573-334-5866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty