Organization
PERRY COUNTY BOARD FOR THE DEVELOPMENTALLY DISABLED
Active
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
Update your record
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