Organization
FORWARD LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC LARON BASTON (EXECUTIVE DIRECTOR)
(816) 820-4231
Entity
Organization
Contact information
Practice address
13107 HERRICK AVE, GRANDVIEW, MO 64030-3548
(816) 820-4231
Mailing address
13107 HERRICK AVE, GRANDVIEW, MO 64030-3548
(816) 820-4231
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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