Organization
WILLOWS WAY, INC
Active
Organization
WILLOWS WAY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN BRENNELL (EXECUTIVE DIRECTOR)
(636) 947-6591
Entity
Organization
Contact information
Practice address
800 FRIEDENS RD STE 100, SAINT CHARLES, MO 63303-4234
(636) 947-6591
(636) 947-8532
Mailing address
800 FRIEDENS RD STE 100, SAINT CHARLES, MO 63303-4234
(636) 947-6591
(636) 947-8532
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268886504
—
MO
05
—
288886500
—
MO
05
—
852962604
—
MO
Enumeration date
10/30/2009
Last updated
10/30/2009
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