Provider Demographics
NPI:1962248013
Name:RED BRICK CARE
Entity type:Organization
Organization Name:RED BRICK CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALVEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-876-3918
Mailing Address - Street 1:3405 E HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-8204
Mailing Address - Country:US
Mailing Address - Phone:417-876-3918
Mailing Address - Fax:
Practice Address - Street 1:3405 E HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:EL DORADO SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64744-8204
Practice Address - Country:US
Practice Address - Phone:417-876-3918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities