Organization
HOLLIS HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MENDY HUFSTEDLER RN (OWNER/ADMINISTRATOR)
(417) 274-3730
Entity
Organization
Contact information
Practice address
8046 COUNTY ROAD 3010, WEST PLAINS, MO 65775-4949
(417) 274-3730
(417) 255-0574
Mailing address
8046 COUNTY ROAD 3010, WEST PLAINS, MO 65775-4949
(417) 274-3730
(417) 255-0574
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/01/2011
Last updated
01/01/2011
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