# THE JODY HOUSE ISL COMPANY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1275773376
- **Authorized official:** CHAD ROBERT LEWIS (DIRECTOR)
- **Authorized official phone:** (573) 465-3654

## Contact information

- **Practice address:** 407 E 6TH ST, ROLLA, MO 65401-3368
- **Practice address phone:** (573) 465-3654
- **Practice address fax:** (888) 858-8055
- **Mailing address:** 407 E 6TH ST, ROLLA, MO 65401-3368
- **Mailing address phone:** (573) 465-3654
- **Mailing address fax:** (888) 858-8055

## Taxonomy

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

## Other

- **Enumeration date:** 03/02/2009
- **Last updated:** 03/02/2009