Organization
GREATER HEIGHTS ADHC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY ALLEN GREENWALT (ADMINISTRATOR)
(573) 431-0344
Entity
Organization
Contact information
Practice address
719 MAPLE ST, FARMINGTON, MO 63640-1925
(573) 756-7554
(573) 756-0227
Mailing address
719 MAPLE ST, FARMINGTON, MO 63640-1925
(573) 756-7554
(573) 756-0227
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
6208-9056
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292756905
—
MO
Enumeration date
03/20/2007
Last updated
05/05/2011
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