Provider Demographics
NPI:1598391963
Name:ROHRBACH SERVICES FOR FAMILIES
Entity type:Organization
Organization Name:ROHRBACH SERVICES FOR FAMILIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHRBACH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-619-1595
Mailing Address - Street 1:471 S FLINT AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-2159
Mailing Address - Country:US
Mailing Address - Phone:417-619-1595
Mailing Address - Fax:417-777-0180
Practice Address - Street 1:109 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-1621
Practice Address - Country:US
Practice Address - Phone:417-619-1595
Practice Address - Fax:417-777-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490040398Medicaid