Maranatha Laura
NPI #1598048571 in Bonne Terre, Missouri
Provider Information
- NPI Number
- 1598048571
- Entity Type
- Organization
- Organization Name
- Maranatha Laura
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Sep 26, 2011
- Last Updated
- Sep 26, 2011
Practice Location
- Address
- 7233 HILLSBORO RD
- City
- Bonne Terre
- State
- Missouri
- ZIP Code
- 63628-3491
- Phone
- (573) 358-4393
Authorized Official
- Name
- MS. LAURA LAVERNE COOK, M.ED.
- Title
- LPC
- Phone
- (573) 358-4393
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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