Organization
BETH GILMORE DBA NEW FOUNDATIONS OF LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH ANN GILMORE (ADMINISTRATOR)
(573) 300-9079
Entity
Organization
Contact information
Practice address
191 HAMPTON CT, POPLAR BLUFF, MO 63901-6707
(573) 300-9079
Mailing address
191 HAMPTON CT, POPLAR BLUFF, MO 63901-6707
(573) 300-9079
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856324504
—
MO
Enumeration date
07/13/2007
Last updated
06/17/2008
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