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Organization

CALLAWAY COUNTY SPECIAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES E. SNOW M. S. (EXECUTIVE DIRECTOR)
(573) 642-1792
Entity
Organization

Contact information

Practice address
911 S BUSINESS 54, FULTON, MO 65251-1406
(573) 642-1792
(573) 642-2415
Mailing address
911 S BUSINESS 54, FULTON, MO 65251-1406
(573) 642-1792
(573) 642-2415

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
N00859770
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
852944305
MO
05
853013803
MO
05
853563906
MO
Enumeration date
06/12/2009
Last updated
06/12/2009
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