# MASHBURN RESIDENTIAL LEARNING CENTER

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

## Provider details

- **NPI number:** 1831248517
- **Authorized official:** LINDA L MASHBURN (OWNER)
- **Authorized official phone:** (417) 326-6512

## Contact information

- **Practice address:** 807 N BRIARWOOD DR, BOLIVAR, MO 65613-1281
- **Practice address phone:** (417) 326-6512
- **Mailing address:** 807 N BRIARWOOD DR, BOLIVAR, MO 65613-1281
- **Mailing address phone:** (417) 326-6512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 14209362 | MO | Yes |

## Other

- **Enumeration date:** 01/10/2007
- **Last updated:** 08/22/2020