Provider Demographics
NPI:1336810548
Name:RELIABLE MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:RELIABLE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SHADDIX
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:636-306-1330
Mailing Address - Street 1:2977 HIGHWAY K STE 141
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7862
Mailing Address - Country:US
Mailing Address - Phone:636-306-1330
Mailing Address - Fax:636-410-9217
Practice Address - Street 1:1103 WARM WINDS DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-6327
Practice Address - Country:US
Practice Address - Phone:636-306-1330
Practice Address - Fax:636-306-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty