Organization
OUR HOUSE MY HOUSE KC, INC.
Active
Organization
OUR HOUSE MY HOUSE KC, INC.
Active
Other names
Our House of KC, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAYLON D WILLIAMS (PROVIDER/ADMINISTRATOR)
(816) 737-8628
Entity
Organization
Contact information
Practice address
9406 E 63RD ST STE B, RAYTOWN, MO 64133-4950
(816) 737-8628
(816) 737-1064
Mailing address
9406 E 63RD ST STE B, RAYTOWN, MO 64133-4950
(816) 737-8628
(816) 737-1064
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
WC1-0190-1211
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
WC1-0190-1211
MO
Other
Enumeration date
03/28/2012
Last updated
04/04/2012
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