Organization
CAUDELL SPECIALIZED CARE INC
Active
Other names
ICAN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROCKY LEE CAUDELL (ADMINISTRATOR)
(816) 254-4226
Entity
Organization
Contact information
Practice address
14300 E 32ND ST S, INDEPENDENCE, MO 64055-2508
(816) 254-4226
Mailing address
14300 E 32ND ST S, INDEPENDENCE, MO 64055-2508
(816) 254-4226
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/08/2008
Last updated
02/08/2008
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