Organization
SPECIALTY PRODUCTS & SERVICES, INC
Active
Other names
Quail Run Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHASTITY ANN COURTER (ADMINISTRATIVE ASSISTANT)
(573) 624-9925
Entity
Organization
Contact information
Practice address
402 S WALNUT ST, DEXTER, MO 63841-2146
(573) 624-9925
(573) 624-9928
Mailing address
402 S WALNUT ST, DEXTER, MO 63841-2146
(573) 624-9925
(573) 624-9928
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
—
857834212
—
MO
Enumeration date
03/21/2007
Last updated
08/16/2011
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