Organization
ROARK I.S.L.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TREVIS WAYNE ROARK (OWNER)
(660) 826-3666
Entity
Organization
Contact information
Practice address
219 W 24TH ST, SEDALIA, MO 65301-8303
(660) 826-3666
(660) 827-9854
Mailing address
219 W 24TH ST, SEDALIA, MO 65301-8303
(660) 826-3666
(660) 827-9854
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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