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Organization

NORTHWEST MISSOURI SUPPORTIVE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARTIN DALE WEATHERD (EXECUTIVE MANAGER)
(816) 827-1254
Entity
Organization

Contact information

Practice address
308 SOUTH PROSPECT, STANBERRY, MO 64489-0222
(660) 783-2464
Mailing address
PO BOX 222, 401 SOUTH STANBERRY STREET, STANBERRY, MO 64489-0222
(660) 783-2842

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
03/06/2007
Last updated
08/22/2020
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