Organization
COMMON GROUND FARMSTEAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK MICHAEL HUNTER (OWNER)
(816) 284-9926
Entity
Organization
Contact information
Practice address
6151 NE 352ND ST, OSBORN, MO 64474-7301
(816) 284-9926
Mailing address
6151 NE 352ND ST, OSBORN, MO 64474-7301
(816) 284-9926
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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