NICKLES PRIVATE PROBATION SERVICES LLC
NPI 1215779665
Clinic/Center - Recovery Care in Steelville, MO
Active since June 07, 2024
About Nickles Private Probation Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICKLES PRIVATE PROBATION SERVICES LLC (NPI 1215779665) is a healthcare organization registered as a recovery care in Steelville, Missouri and active in the NPI registry since June 2024. The organization maintains a secondary practice location in Potosi and lists Kenneth Lee Nickles, Sole Member, as its authorized official.
NPPES Registry Identity
NPI1215779665
Entity TypeOrganization
Primary Taxonomy261QR0800X
Legal Business NameNICKLES PRIVATE PROBATION SERVICES LLC
Location Address205 3RD STSteelville, MO 65565-5054
Mailing AddressPo Box 1325Steelville, MO 65565-1325 · (573) 712-5145 · Fax (630) 604-9287
Phone(573) 712-5145
Fax(630) 305-9287
Organization SubpartNo
Authorized OfficialKenneth Lee NicklesSole Member · (573) 712-5145
Enumeration DateJune 7, 2024
NPPES CertifiedJune 7, 2024
✔ NPI 1215779665 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · Recovery CareAmbulatory Health Care Facilities
Taxonomy Code261QR0800X
205 3RD ST, Steelville, MO 65565
Secondary Practice Location 1
Location 1114 E High StPotosi, MO 63664-1907 · Phone (573) 712-5145 · Fax (630) 305-9287
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215779665, enumerated as an "organization" on June 07, 2024.
The provider is located at 205 3RD ST STEELVILLE, MO 65565 and the phone number is (573) 712-5145.
Clinic/Center with taxonomy code 261QR0800X and a focus in Recovery Care.
