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Organization
VICTORY MOUNTAIN, INC.
Active
Organization
VICTORY MOUNTAIN, INC.
Active
Other names
Victory Mountain Boys Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER SHAWN SKINNER M.A., L.P.C. (PRESIDENT)
(573) 546-7592
Entity
Organization
Contact information
Practice address
148 BOWLING LN, IRONTON, MO 63650-4148
(573) 546-7592
(573) 546-0125
Mailing address
148 BOWLING LN, IRONTON, MO 63650-4148
(573) 546-7592
(573) 546-0125
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
001770712
MO
Other
Enumeration date
04/22/2010
Last updated
04/22/2010
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