Individual
MRS. GEORGETTE ELDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
704 NW MEADOW RD, GRAIN VALLEY, MO 64029-7314
(816) 847-0332
(816) 847-0332
Mailing address
704 NW MEADOW RD, GRAIN VALLEY, MO 64029-7314
(816) 847-0332
(816) 847-0332
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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