Organization
RUTH JENSEN VILLAGE RESIDENTIAL SERVICES, INC. OHCDS CONTRACT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA R BURT (BUSINESS MANAGER)
(573) 324-6580
Entity
Organization
Contact information
Practice address
5 INDUSTRIAL DR, BOWLING GREEN, MO 63334-2436
(573) 324-3580
(573) 324-6323
Mailing address
5 INDUSTRIAL DR, BOWLING GREEN, MO 63334-2436
(573) 324-3580
(573) 324-6323
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1422-9250
MO
Other
Enumeration date
06/05/2007
Last updated
08/22/2020
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