Organization
RENOVO BOYS ACADEMY
Active
Parent organization
PROFICIO MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROFICIO MANAGEMENT
Authorized official
BRIAN L ALLRED LPC (CEO)
(573) 384-5755
Entity
Organization
Contact information
Practice address
308 BUCK CREEK RD, SILEX, MO 63377-2116
(573) 384-5755
Mailing address
240 MAGEE ST, SUITE 320, TROY, MO 63379-3182
(573) 384-5755
(573) 384-5756
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
002109748
MO
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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