Organization
VICTORY MOUNTAIN, INC.
Active
Other names
Victory Mountain Boys Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER SHAWN SKINNER M.A., L.P.C. (PRESIDENT)
(573) 546-7592
Entity
Organization
Contact information
Practice address
148 BOWLING LN, IRONTON, MO 63650-4148
(573) 546-7592
(573) 546-0125
Mailing address
148 BOWLING LN, IRONTON, MO 63650-4148
(573) 546-7592
(573) 546-0125
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
001770712
MO
Other
Enumeration date
04/22/2010
Last updated
04/22/2010
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