Organization
ANNA DODSON HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY MCDOWELL (MAIN MEMBER/ADMINISTRATOR)
(573) 631-3644
Entity
Organization
Contact information
Practice address
4616 HWY D, FARMINGTON, MO 63640-7241
(573) 756-5530
(573) 756-5530
Mailing address
4616 HWY D, FARMINGTON, MO 63640-7241
(573) 756-5530
(573) 756-5530
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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