Organization
BEACONWAY III, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN LANCE (REGIONAL DIRECTOR)
(660) 229-0175
Entity
Organization
Contact information
Practice address
441 NORTH DR, MARSHALL, MO 65340-3309
(660) 229-0175
(660) 831-1189
Mailing address
441 NORTH DR, MARSHALL, MO 65340-3309
(660) 229-0175
(660) 831-1189
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/11/2008
Last updated
02/26/2008
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