Organization
MACON COUNTY SHELTERED WORKSHOP
Active
Other names
Macon Diversified Industries
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN D SPIDLE (OFFICE MANAGER)
(660) 385-3111
Entity
Organization
Contact information
Practice address
1103 ENTERPRISE RD, MACON, MO 63552-1305
(660) 385-3111
(660) 395-9578
Mailing address
1103 ENTERPRISE RD, MACON, MO 63552-1305
(660) 385-3111
(660) 395-9578
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M857758502
—
MO
Enumeration date
03/23/2020
Last updated
03/23/2020
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