Organization
MAURIZI ISL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA D MAURIZI (OWNER)
(573) 256-1296
Entity
Organization
Contact information
Practice address
2015 WOODHOLLOW DR, COLUMBIA, MO 65203-0909
(573) 256-1296
(573) 256-1016
Mailing address
2015 WOODHOLLOW DR, COLUMBIA, MO 65203-0909
(573) 256-1296
(573) 256-1016
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
856917109
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856917109
—
MO
Enumeration date
03/07/2007
Last updated
04/09/2008
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