Organization
NEW TRAILS, LLC - 4TH STREET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE ANN MANION (OWNER/DIRECTOR)
(660) 783-2392
Entity
Organization
Contact information
Practice address
201 E 4TH ST, STANBERRY, MO 64489-1211
(660) 783-2392
Mailing address
4578 US HIGHWAY 136, STANBERRY, MO 64489-8124
(660) 783-2392
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
08/01/2007
Last updated
08/02/2007
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