Organization
LAFAYETTE COUNTY BOARD OF SHELTERED SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS T. WHITLOCK (EXECUTIVE DIRECTOR)
(660) 584-3101
Entity
Organization
Contact information
Practice address
312 W 19TH ST, HIGGINSVILLE, MO 64037-1513
(660) 584-3101
Mailing address
312 W 19TH ST, HIGGINSVILLE, MO 64037-1513
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6606199
—
MO
Enumeration date
03/26/2007
Last updated
09/11/2025
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