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Organization
JAYS RESIDENTIAL LLC - TREVIS HOUSE
Active
Organization
JAYS RESIDENTIAL LLC - TREVIS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LEE RUDOLPH BS (DIRECTOR)
(816) 456-6461
Entity
Organization
Contact information
Practice address
12731 RICHMOND AVE, GRANDVIEW, MO 64030-2160
(816) 456-6461
(816) 965-0131
Mailing address
12731 RICHMOND AVE, GRANDVIEW, MO 64030-2160
(816) 456-6461
(816) 965-0131
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
03/26/2007
Last updated
08/22/2020
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