Whalio Doctors

NPI 1417340357

Jefferson Manor

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Cape Girardeau, MO

Practice location

Address
902 Jefferson Ave, Cape Girardeau, MO 63703-6755
Phone
(573) 651-1373
Fax
(573) 651-1373

Authorised official

Name
Sharon Louise Armour
Title
Operator
Phone
(573) 651-1373

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X Licence 041432 (MO)

Registry record

NPI
1417340357
Entity type
Organization
NPI issued
17 Mar 2015
Record last updated
17 Mar 2015

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.