Provider Demographics
NPI:1396148078
Name:CATHOLIC CHARITIES OF SOUTHERN MISSOURI FOR CAPE COUNTY
Entity type:Organization
Organization Name:CATHOLIC CHARITIES OF SOUTHERN MISSOURI FOR CAPE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNARDINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-720-4213
Mailing Address - Street 1:424 E MONASTERY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-6099
Mailing Address - Country:US
Mailing Address - Phone:417-720-4213
Mailing Address - Fax:417-720-4216
Practice Address - Street 1:231 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-7221
Practice Address - Country:US
Practice Address - Phone:573-335-0905
Practice Address - Fax:573-335-0988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARITIES OF SOUTHERN MISSOURI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-08
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management