Organization
BRINKLEY ISL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA MARIE BRINKLEY (ADMINISTRATOR)
(573) 289-2171
Entity
Organization
Contact information
Practice address
411 SACKETTS RD, COLUMBIA, MO 65202-9811
(573) 289-2171
Mailing address
411 SACKETTS RD, COLUMBIA, MO 65202-9811
(573) 289-2171
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/21/2007
Last updated
11/21/2007
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