Organization
DILLAHUNT ENTERPRISES, LLC
Active
Organization
DILLAHUNT ENTERPRISES, LLC
Active
Other names
Dillahunt ISL
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY JANE DILLAHUNT (PROVIDER)
(573) 445-4408
Entity
Organization
Contact information
Practice address
4300 ROYAL ABERDEEN ST, COLUMBIA, MO 65203-4810
(573) 445-4408
(573) 445-4408
Mailing address
4300 ROYAL ABERDEEN ST, COLUMBIA, MO 65203-4810
(573) 445-4408
(573) 445-4408
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
093669
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/12/2016
Last updated
03/03/2016
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