Lasting Impressions Group Home

NPI 1235349614 - Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities - 320900000X

NPI Details
NPI 1235349614
Enumeration Date 05/23/2007
Last Updated 10/07/2014
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SHANNON DEE SHANNON
Position DIRECTOR
Phone (660) 343-3681
Fax (660) 343-5871
Practice Location
308 E SMITH ST
SMITHTON MO, 65350-1079, US
Phone (660) 343-3681
Fax (660) 343-5871
Business Location
PO BOX 513
SMITHTON MO, 65350-0513, US
Phone (660) 343-3681
Fax (660) 343-5871
Toxanomy
Taxonomy Code 320900000X
License State
License Number
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According to our database, Lasting Impressions Group Home NPI is 1235349614, taxonomy code is 320900000X Lasting Impressions Group Home physically located at 308 E Smith St, Smithton MO, 65350-1079. NPI Number 1033115704 has the healthcare provider type.

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1235349614 NPI number is provided on an as is basis without warranty of any kind. 1235349614 is maintained by the National Plan & Provider Enumeration System. The contents of Lasting Impressions Group Home are for informational purposes only.