Organization
SOUTHEAST MISSOURI STATE UNIVERSITY
Active
Other names
Horizons Enrichment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY LYNNE OWENS BSPA (DIRECTOR)
(573) 290-5115
Entity
Organization
Contact information
Practice address
2100 THEMIS ST STE 103C, CAPE GIRARDEAU, MO 63701-5124
(573) 290-5115
(573) 290-5142
Mailing address
2100 THEMIS ST STE 103C, CAPE GIRARDEAU, MO 63701-5124
(573) 290-5115
(573) 290-5142
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780753640
—
MO
Enumeration date
08/05/2011
Last updated
02/15/2019
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