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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