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Organization

PERRY COUNTY BOARD FOR THE DEVELOPMENTALLY DISABLED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVE RICHARDET (BOARD PRESIDENT SENATE BILL 40)
(573) 547-2158
Entity
Organization

Contact information

Practice address
618 INDUSTRIAL DR, SUITE A, PERRYVILLE, MO 63775-1200
(573) 547-6639
(573) 517-0401
Mailing address
618 INDUSTRIAL DR, SUITE A, PERRYVILLE, MO 63775-1200
(573) 547-6639
(573) 517-0401

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251B0000X
251B00000X
Case Management Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
159920305
MO
Enumeration date
04/30/2008
Last updated
01/21/2009
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