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Organization
WILLOW CREEK ISL, LLC
Active
Organization
WILLOW CREEK ISL, LLC
Active
Other names
Willow Creek Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN DENISON (OWNER)
(816) 225-8214
Entity
Organization
Contact information
Practice address
1008 EDITH AVE., ADRIAN, MO 64720
(816) 225-8214
(816) 297-4032
Mailing address
1008 EDITH AVE., ADRIAN, MO 64720
(816) 225-8214
(816) 297-4032
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
855188900
MO
Other
Enumeration date
04/04/2007
Last updated
12/03/2021
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