Organization
TWIN LAKES COMMUNITY SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID EARL WATSON BSSP (DIRECTOR)
(660) 438-8599
Entity
Organization
Contact information
Practice address
16727 WALNUT GROVE RD, WARSAW, MO 65355-5750
(660) 438-8599
(660) 438-8584
Mailing address
16727 WALNUT GROVE RD, WARSAW, MO 65355-5750
(660) 438-8599
(660) 438-8584
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8001556
DMH VENDER NUMBER
MO
Enumeration date
12/18/2006
Last updated
08/22/2020
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