# KELLEY L YEOKUM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104967637
- **Authorized official:** MRS. KELLEY LYNN YEOKUM MSE (SOLE PROPRIETOR)
- **Authorized official phone:** (816) 419-7106

## Contact information

- **Practice address:** 27421 S STATE ROUTE 2, FREEMAN, MO 64746-7102
- **Practice address phone:** (816) 250-2398
- **Practice address fax:** (816) 250-2398
- **Mailing address:** 27421 S STATE ROUTE 2, FREEMAN, MO 64746-7102
- **Mailing address phone:** (816) 250-2398
- **Mailing address fax:** (816) 250-2398

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 62819415 | MO | Yes |

## Other

- **Enumeration date:** 02/09/2007
- **Last updated:** 06/30/2008