Organization
BETHESDA LUTHERAN HOMES & SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN HOLTON (DIRECTOR OF ACCOUNTING)
(920) 206-4458
Entity
Organization
Contact information
Practice address
2608 AURORA AVE, MARYVILLE, MO 64468-3608
(660) 582-7371
(660) 582-2791
Mailing address
600 HOFFMANN DR, WATERTOWN, WI 53094-6223
(920) 261-3050
(920) 206-7711
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856243100
—
MO
Enumeration date
05/09/2007
Last updated
11/24/2010
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