Provider Demographics
NPI:1063586519
Name:CHILD ABUSE & NEGLECT EMERGENCY SHELTER, INC.
Entity type:Organization
Organization Name:CHILD ABUSE & NEGLECT EMERGENCY SHELTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:573-474-6600
Mailing Address - Street 1:1611 TOWNE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-2339
Mailing Address - Country:US
Mailing Address - Phone:573-474-6600
Mailing Address - Fax:573-474-5992
Practice Address - Street 1:1611 TOWNE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-2339
Practice Address - Country:US
Practice Address - Phone:573-474-6600
Practice Address - Fax:573-474-5992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO242366251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable