Northwest Missouri Supportive Services

NPI 1093844722 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1093844722
Enumeration Date 03/06/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARTIN DALE MARTIN
Position EXECUTIVE MANAGER
Phone (660) 783-2464
Fax
Practice Location
308 SOUTH PROSPECT
STANBERRY MO, 64489-0222, US
Phone (660) 783-2464
Fax
Business Location
PO BOX 222
401 SOUTH STANBERRY STREET
STANBERRY MO, 64489-0222, US
Phone (660) 783-2842
Fax
Toxanomy
Taxonomy Code 320600000X
License State
License Number
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According to our database, Northwest Missouri Supportive Services NPI is 1093844722, taxonomy code is 320600000X Northwest Missouri Supportive Services physically located at 308 South Prospect, Stanberry MO, 64489-0222. NPI Number 1033115704 has the healthcare provider type.

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1093844722 NPI number is provided on an as is basis without warranty of any kind. 1093844722 is maintained by the National Plan & Provider Enumeration System. The contents of Northwest Missouri Supportive Services are for informational purposes only.