Organization
SPECIAL T ACRES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LELAND TIMM (ADMINISTRATOR)
(417) 286-3639
Entity
Organization
Contact information
Practice address
3590 STOUTLAND CREEK RD, STOUTLAND, MO 65567
(417) 286-4907
(417) 286-3907
Mailing address
3590 STOUTLAND CREEK RD, STOUTLAND, MO 65567
(417) 286-4907
(417) 286-3907
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
855178703
—
MO
Enumeration date
04/06/2007
Last updated
07/08/2008
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