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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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