Organization
COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM BAILEY (OWNER)
(573) 837-6096
Entity
Organization
Contact information
Practice address
23043 COUNTY ROAD 316, ORAN, MO 63771-8215
(573) 837-6096
Mailing address
23043 COUNTY ROAD 316, ORAN, MO 63771-8215
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8596915206
—
MO
Enumeration date
05/17/2007
Last updated
08/22/2020
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