NPI: 1508311747 · MARYVILLE, MO 64468 · Physical Disabilities Residential Treatment Facility · NPI assigned 08/17/2016
| Authorized Official | DASAL, MATHIAS (MEMBER) |
| NPI Enumeration Date | 08/17/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $74.62 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| Q3014 | Telehealth originating site facility fee | 13 | 12 | $74.62 |