Organization
MISSOURI GIRLS TOWN FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROY FOWLES (EXECUTIVE DIRECTOR)
(573) 642-5345
Entity
Organization
Contact information
Practice address
8548 JADE ROAD, KINGDOM CITY, MO 65262
(573) 642-5345
(573) 642-0891
Mailing address
PO BOX 59, 8548 JADE ROAD, KINGDOM CITY, MO 65262-0059
(573) 642-5345
(573) 642-0891
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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