Organization
MAPLE RIDGE RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANDERSON (SECRETARY)
(573) 546-1616
Entity
Organization
Contact information
Practice address
1034 DORIS DR, FARMINGTON, MO 63640-1954
(573) 760-0155
(573) 760-0524
Mailing address
231 S MAIN ST, SUITE B, IRONTON, MO 63650-1307
(573) 546-1616
(573) 546-6465
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
033512
MO
Other
Enumeration date
03/26/2007
Last updated
08/22/2020
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