NPI 1164603072

Mi Serenity

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Rolla, MO

Practice location

Address: 11840 Private Drive 5136, Rolla, MO 65401-5909
Phone: (573) 368-4899

Authorised official

Name: Teddy Eugene Ruth
Title: Ceo
Phone: (573) 368-4899

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Missouri →

Registry record

NPI: 1164603072
Entity type: Organization
NPI issued: 19 Nov 2007
Record last updated: 19 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.