Organization
FERNDALE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA JEAN GILBERT (HOUSE MANAGER)
(573) 265-3344
Entity
Organization
Contact information
Practice address
15677 COUNTY ROAD 2430, ST JAMES, MO 65559-8210
(573) 265-3344
(573) 265-1119
Mailing address
15677 COUNTY ROAD 2430, ST JAMES, MO 65559-8210
(573) 265-3344
(573) 265-1119
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856796503
—
MO
Enumeration date
04/03/2007
Last updated
06/29/2011
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