Organization
WILLIAMS MARK TWAIN GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT WILLIAMS (OWNER)
(573) 221-0297
Entity
Organization
Contact information
Practice address
511 BIRCH ST, HANNIBAL, MO 63401-5001
(573) 221-0297
(573) 406-1418
Mailing address
511 BIRCH ST, HANNIBAL, MO 63401-5001
(573) 406-1418
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2588-8531
MO
Other
Enumeration date
04/16/2007
Last updated
08/22/2020
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