Organization
BEACON WAY 111
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCY S SORENSEN (DIRECTOR)
(660) 448-3097
Entity
Organization
Contact information
Practice address
3411 STATE HIGHWAY 85, ALBANY, MO 64402-8335
(660) 726-3415
Mailing address
441 NORTH DR, MARSHALL, MO 65340-3309
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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