Organization
MCWILLIAMS MANOR, INCORPORATED
Active
Parent organization
MCWILLIAMS MANOR, INCORPORATED
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCWILLIAMS MANOR, INCORPORATED
Authorized official
MR. RICHARD MCWILLIAMS (OWNER)
(573) 785-4035
Entity
Organization
Contact information
Practice address
3439 S WESTWOOD BLVD, POPLAR BLUFF, MO 63901-8670
(573) 785-4035
(573) 785-4035
Mailing address
3439 S WESTWOOD BLVD, POPLAR BLUFF, MO 63901-8670
(573) 785-4035
(573) 785-4035
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
7048378
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
7048378
MO
385H00000X
Respite Care
7048378
MO
Other
Enumeration date
03/26/2007
Last updated
01/22/2008
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