Organization
DIANA'S BOARDING HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA F COOK (PRESIDENT/OWNER)
(573) 238-3344
Entity
Organization
Contact information
Practice address
HC 64 BOX 4677, MARBLE HILL, MO 63764-9408
(573) 238-3344
(573) 238-3361
Mailing address
HC64 BOX 4677, DIANA'S BOARDING HOME, INC, MARBLE HILL, MO 63764
(573) 238-3344
(573) 238-3361
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
300-10547
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M266733518
—
MO
Enumeration date
07/23/2008
Last updated
07/23/2008
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