Organization
MELISSA A STEWART
Active
Other names
Melissa's Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA A STEWART BS (OWNER)
(573) 471-4219
Entity
Organization
Contact information
Practice address
106 DACUS, SIKESTON, MO 63801
(573) 471-4219
Mailing address
106 DACUS DR, SIKESTON, MO 63801-9013
(573) 471-4219
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
13678892
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853126100
—
MO
Enumeration date
03/23/2007
Last updated
09/18/2015
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