Willow Creek South Group Home

NPI 1538281019 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1538281019
Enumeration Date 04/04/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JEANIE SUE JEANIE
Position OWNER
Phone (816) 297-8956
Fax (816) 297-4032
Practice Location
RR 2 BOX 27
ADRIAN MO, 64720-9587, US
Phone (816) 297-8956
Fax (816) 297-4032
Business Location
RR 2 BOX 27
ADRIAN MO, 64720-9587, US
Phone (816) 297-8956
Fax (816) 297-4032
Toxanomy
Taxonomy Code 320600000X
License State
License Number
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According to our database, Willow Creek South Group Home NPI is 1538281019, taxonomy code is 320600000X Willow Creek South Group Home physically located at Rr 2 Box 27, Adrian MO, 64720-9587. NPI Number 1033115704 has the healthcare provider type.

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1538281019 NPI number is provided on an as is basis without warranty of any kind. 1538281019 is maintained by the National Plan & Provider Enumeration System. The contents of Willow Creek South Group Home are for informational purposes only.