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Organization
BROOKWOOD GROUP HOME
Active
Organization
BROOKWOOD GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY D BOGGS (PRESIDENT)
(417) 722-4416
Entity
Organization
Contact information
Practice address
RR 1 BOX 1560, CROSS TIMBERS, MO 65634-9721
(417) 998-6502
(417) 722-4417
Mailing address
27 HOPPER TRL, URBANA, MO 65767-9234
(417) 722-4416
(417) 722-4417
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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