Organization
GMT FAMILY ENTERPRISE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK DEWAYNE GRIGSBY (PRESIDENT)
(417) 772-4028
Entity
Organization
Contact information
Practice address
305 5TH ST, MONETT, MO 65708-2312
(417) 772-4028
(417) 235-5959
Mailing address
310 DAIRY ST, MONETT, MO 65708-2521
(417) 772-4028
(417) 235-5959
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M267903904
—
MO
Enumeration date
01/17/2019
Last updated
01/17/2019
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