Organization
OUTREACH SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY KAY TEEL RN (EXECUTIVE DIRECTOR)
(573) 268-1367
Entity
Organization
Contact information
Practice address
5014 ROUTE D, RUSSELLVILLE, MO 65074-2244
(573) 268-1367
Mailing address
5014 ROUTE D, RUSSELLVILLE, MO 65074-2244
(573) 268-1367
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
LC1334934
MO
Other
Enumeration date
09/27/2013
Last updated
11/20/2016
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