Organization
COTONEASTER INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA ANN SMITH (VICE PRESIDENT)
(573) 333-5777
Entity
Organization
Contact information
Practice address
509 WARD AVE, CARUTHERSVILLE, MO 63830-1661
(573) 333-5777
Mailing address
509 WARD AVE, CARUTHERSVILLE, MO 63830-1661
(573) 333-5777
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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