# MISSOURI GIRLS TOWN FOUNDATION, INC

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

## Provider details

- **NPI number:** 1831253137
- **Authorized official:** MR. ROY FOWLES (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (573) 642-5345

## Contact information

- **Practice address:** 8548 JADE ROAD, KINGDOM CITY, MO 65262
- **Practice address phone:** (573) 642-5345
- **Practice address fax:** (573) 642-0891
- **Mailing address:** PO BOX 59, 8548 JADE ROAD, KINGDOM CITY, MO 65262-0059
- **Mailing address phone:** (573) 642-5345
- **Mailing address fax:** (573) 642-0891

## Taxonomy

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

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020