Organization
ROARK ISL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA K ROARK (OWNER)
(660) 826-0244
Entity
Organization
Contact information
Practice address
219 W 24TH ST, SEDALIA, MO 65301-8303
(660) 826-0244
(660) 829-4872
Mailing address
27880 HACKBERRY DR, SEDALIA, MO 65301-0561
(660) 826-0244
(660) 829-4872
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
CC1-0207-0413
MO
Other
Enumeration date
01/30/2014
Last updated
04/07/2014
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