1386885754 NPI number — NACIA NATL ANTI-CRIME INST OF AMER

Table of content: (NPI 1386885754)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386885754 NPI number — NACIA NATL ANTI-CRIME INST OF AMER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NACIA NATL ANTI-CRIME INST OF AMER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATIONAL ANTI-CRIME INSTITUTE OF AMERICA, INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386885754
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
305 E WALNUT ST
Provider Second Line Business Mailing Address:
STE 100/104
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65806-2301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-832-1890
Provider Business Mailing Address Fax Number:
417-522-5234

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2733 E BATTLEFIELD ST # 226
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65804-3981
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-832-1890
Provider Business Practice Location Address Fax Number:
417-522-5234
Provider Enumeration Date:
03/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OPERATIONS DIRECTOR
Authorized Official Telephone Number:
417-832-1890

Provider Taxonomy Codes

  • Taxonomy code: 1041S0200X , with the licence number:  BUS2001-04620 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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