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Organization

LIVES WITHOUT LIMITS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS DORIS REAN SMITH (SECUTARY)
(816) 726-0281
Entity
Organization

Contact information

Practice address
102 S MYRTLE ST, EXCELSIOR SPRINGS, MO 64024-2036
(816) 726-0281
Mailing address
102 S MYRTLE ST, EXCELSIOR SPRINGS, MO 64024-2036
(816) 726-0281

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MO

Other

Enumeration date
10/26/2007
Last updated
10/26/2007
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