Organization
RUDROFF ISL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY MARK RUDROFF (ADMINISTRATOR OWNER)
(573) 897-4700
Entity
Organization
Contact information
Practice address
1207 E MAIN ST, LINN, MO 65051
(573) 897-4700
(573) 897-0256
Mailing address
1205 E MAIN ST, LINN, MO 65051-2502
(573) 897-4700
(573) 897-0256
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
04/27/2007
Last updated
08/22/2020
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