Organization
WILLOW CREEK GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANIE SUE STEPHENS (OWNER)
(816) 297-8956
Entity
Organization
Contact information
Practice address
RR 2 BOX 27, ADRIAN, MO 64720-9587
(816) 297-8956
(816) 297-4032
Mailing address
RR 2 BOX 27, ADRIAN, MO 64720-9587
(816) 297-8956
(816) 297-4032
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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