Organization
BEACON WAY II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMMA J GORSLINE (ADMINISTRATOR)
(660) 726-3734
Entity
Organization
Contact information
Practice address
406 N RAILROAD ST, ALBANY, MO 64402-2403
(816) 390-3840
Mailing address
5658 STATE HIGHWAY J, ALBANY, MO 64402-8113
(660) 726-3734
(660) 726-3366
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/23/2007
Last updated
07/03/2008
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