Organization
WILLIAMS RESIDENTIAL 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOUISE JEAN WILLIAMS (ADMINISTRATOR)
(573) 221-3237
Entity
Organization
Contact information
Practice address
203 N MAPLE AVE, HANNIBAL, MO 63401-3408
(573) 221-3237
Mailing address
PO BOX 1073, HANNIBAL, MO 63401-1073
(573) 221-3237
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/24/2008
Last updated
01/13/2009
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