# RENOVO BOYS ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROFICIO MANAGEMENT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689839763
- **Legal business name:** PROFICIO MANAGEMENT
- **Authorized official:** BRIAN L ALLRED LPC (CEO)
- **Authorized official phone:** (573) 384-5755

## Contact information

- **Practice address:** 308 BUCK CREEK RD, SILEX, MO 63377-2116
- **Practice address phone:** (573) 384-5755
- **Mailing address:** 240 MAGEE ST, SUITE 320, TROY, MO 63379-3182
- **Mailing address phone:** (573) 384-5755
- **Mailing address fax:** (573) 384-5756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 002109748 | MO | Yes |

## Other

- **Enumeration date:** 07/28/2008
- **Last updated:** 07/28/2008