Organization
DIANAS BOARDING HOME INC
Active
Other names
Diana's Boarding Home #3
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA FAYE COOK (OWNER/PRESIDENT)
(573) 238-1300
Entity
Organization
Contact information
Practice address
HC 64, BOX 4683, MARBLE HILL, MO 63764
(573) 238-1300
(573) 238-1302
Mailing address
HC 64 BOX 4683, MARBLE HILL, MO 63764
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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