Organization
J & J ASSISTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON CHARLES PIERCE (ADMINISTRATOR)
(573) 238-4602
Entity
Organization
Contact information
Practice address
104 WESBECHER, MARBLE, MO 63764
(573) 238-1008
(573) 238-3233
Mailing address
PO BOX 378, MARBLE HILL, MO 63764-0378
(573) 238-4602
(573) 238-3233
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
034164
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M268918505
—
MO
Enumeration date
06/16/2008
Last updated
06/16/2008
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