Organization
ALLEN SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARLET SUE ALLEN (ADMINISTRATOR)
(417) 264-2272
Entity
Organization
Contact information
Practice address
RT 3 3268A, THAYER, MO 65791
(417) 264-2272
Mailing address
3268A RT 3, THAYER, MO 65791
(417) 264-2272
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/23/2007
Last updated
08/30/2007
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