Organization
LBENHOLDINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN CHARLES MAKLER (OWNER)
(573) 330-3219
Entity
Organization
Contact information
Practice address
301 WATTS ST, PARK HILLS, MO 63601-1839
(573) 330-3219
Mailing address
PO BOX 12, PARK HILLS, MO 63601-0012
(573) 330-3219
(573) 431-4874
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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