Conway Group Home Ii

NPI 1063532281 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1063532281
Enumeration Date 03/30/2007
Last Updated 08/08/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KATHERINE A KATHERINE
Position OWNER
Phone (573) 688-2886
Fax
Practice Location
310 PHILLIPS
LILBOURN MO, 63862, US
Phone (573) 688-2886
Fax
Business Location
PO BOX 353
310 PHILLIPS
LILBOURN MO, 63862, US
Phone (573) 688-2886
Fax
Toxanomy
Taxonomy Code 320600000X
License State Missouri
License Number 15448196
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According to our database, Conway Group Home Ii NPI is 1063532281, taxonomy code is 320600000X and license number is 15448196, license state is located at Missouri. Conway Group Home Ii physically located at 310 Phillips, Lilbourn MO, 63862. NPI Number 1033115704 has the healthcare provider type.

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1063532281 NPI number is provided on an as is basis without warranty of any kind. 1063532281 is maintained by the National Plan & Provider Enumeration System. The contents of Conway Group Home Ii are for informational purposes only.