# WYATT HOUSE

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

## Provider details

- **NPI number:** 1902029325
- **Authorized official:** PAUL D THROCKMORTON (DIRECTOR)
- **Authorized official phone:** (417) 537-8858

## Contact information

- **Practice address:** 707 WYATT AVE, GOLDEN CITY, MO 64748-8300
- **Practice address phone:** (417) 537-8858
- **Practice address fax:** (417) 537-4203
- **Mailing address:** 707 WYATT AVE, PO BOX 459, GOLDEN CITY, MO 64748-8300
- **Mailing address phone:** (417) 537-8858
- **Mailing address fax:** (417) 537-4203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 5687-9292 | MO | Yes |

## Other

- **Enumeration date:** 04/11/2007
- **Last updated:** 08/22/2020