# WILLOW CREEK ISL

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

## Provider details

- **NPI number:** 1326261595
- **Authorized official:** MRS. JEANIE SUE STEPHENS (OWNER)
- **Authorized official phone:** (816) 297-8956

## Contact information

- **Practice address:** RR 2 BOX 27, ADRIAN, MO 64720-9587
- **Practice address phone:** (816) 297-2833
- **Mailing address:** RR 2 BOX 27, ADRIAN, MO 64720-9587
- **Mailing address phone:** (816) 297-8956

## Taxonomy

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

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 08/22/2020