Organization
MELISSA A STEWART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA A STEWART (OWNER/ADMINISTRATOR)
(573) 471-4219
Entity
Organization
Contact information
Practice address
106 DACUS DRIVE, SIKESTON, MO 63801-3801
(573) 471-4219
Mailing address
106 DACUS DRIVE, SIKESTON, MO 63801-3801
(573) 471-4219
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
04/16/2012
Last updated
10/01/2015
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