# WILLIAMS MARK TWAIN GROUP HOME

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

## Provider details

- **NPI number:** 1760607766
- **Authorized official:** ALBERT WILLIAMS (OWNER)
- **Authorized official phone:** (573) 221-0297

## Contact information

- **Practice address:** 511 BIRCH ST, HANNIBAL, MO 63401-5001
- **Practice address phone:** (573) 221-0297
- **Practice address fax:** (573) 406-1418
- **Mailing address:** 511 BIRCH ST, HANNIBAL, MO 63401-5001
- **Mailing address fax:** (573) 406-1418

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 2588-8531 | MO | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 08/22/2020