Organization
HOLLAND RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAWANA JENKINS MPA, MSW (EXECUTIVE DIRECTOR)
(816) 982-9481
Entity
Organization
Contact information
Practice address
12510 JACKSON AVE, GRANDVIEW, MO 64030-1593
(816) 982-9481
Mailing address
12510 JACKSON AVE, GRANDVIEW, MO 64030-1593
(816) 982-9481
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/28/2019
Last updated
04/28/2019
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