Organization
WILLOW BROOKE HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY R MATTHEW (ASSIST. ADMINISTRATOR)
(816) 456-2375
Entity
Organization
Contact information
Practice address
1903 STACY RD, HARRISONVILLE, MO 64701-3574
(816) 380-2143
Mailing address
1903 STACY RD, HARRISONVILLE, MO 64701-3574
(816) 380-2143
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
MO
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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