Organization
RANDOLPH COUNTY DEVELOPMENTAL DISABILITY SERVICES
Active
Organization
RANDOLPH COUNTY DEVELOPMENTAL DISABILITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MINDY BETH BREID (DIRECTOR OF ADMINISTRATION)
(660) 269-8875
Entity
Organization
Contact information
Practice address
101 W COATES ST, MOBERLY, MO 65270-1521
(660) 269-8875
(660) 269-9621
Mailing address
PO BOX 1008, MOBERLY, MO 65270-0975
(660) 269-8875
(660) 269-9621
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159041201
—
MO
Enumeration date
03/06/2012
Last updated
09/04/2012
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