Organization
SHERRODS FOSTER HOME AND ISL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HESTER B HANDY (ADMINISTRATIVI)
(573) 276-3640
Entity
Organization
Contact information
Practice address
43654 STATE HIGHWAY 25, MALDEN, MO 63863-9492
(573) 276-3640
Mailing address
43654 STATE HIGHWAY 25, MALDEN, MO 63863-9492
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
393-6116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853851400
—
MO
Enumeration date
03/21/2007
Last updated
07/21/2008
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