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Organization

JAYS RESIDENTIAL, LLC - GRANDVIEW II

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON L RUDOLPH (DIRECTOR)
(816) 456-6461
Entity
Organization

Contact information

Practice address
12731 RICHMOND AVE, GRANDVIEW, MO 64030-2160
(816) 456-6461
(816) 965-0131
Mailing address
12731 RICHMOND AVE, GRANDVIEW, MO 64030-2160
(816) 456-6461
(816) 965-0131

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
10/23/2007
Last updated
10/23/2007
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