Organization
LIFEQUEST SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SMITH (CO-OWNER)
(417) 274-9471
Entity
Organization
Contact information
Practice address
99 ROYAL VISTA DR UNIT 408, BRANSON, MO 65616-6237
(417) 274-9471
Mailing address
99 ROYAL VISTA DR UNIT 408, BRANSON, MO 65616-6237
(417) 274-9471
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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