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Organization

STILE II

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NEIL RICHARD BOLINE M.S.W. (DIRECTOR)
(816) 532-0512
Entity
Organization

Contact information

Practice address
2004 BROOK DR, SMITHVILLE, MO 64089-8967
(816) 532-0512
(816) 532-0512
Mailing address
2004 BROOK DR, SMITHVILLE, MO 64089-8967
(816) 532-0512
(816) 532-0512

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
05/22/2007
Last updated
08/22/2020
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