NPI 1841452109

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Organisation Intellectual Disabilities Intermediate Care Facility Urbana, MO

Practice location

Address: 27 Hopper Trl, Urbana, MO 65767-9234
Phone: (417) 722-4416
Fax: (417) 722-4417

Authorised official

Name: Gary D Boggs
Title: Director
Phone: (417) 722-4416

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence LC0556542 (MO)

Other Intermediate Care Facility, Intellectual Disabilities providers in Missouri →

Registry record

NPI: 1841452109
Entity type: Organization
NPI issued: 27 Jun 2008
Record last updated: 27 Jun 2008

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.