Madison County Council for Developmentally Disabled, Inc.

Organization Active NPI Case Management Agency · Fredericktown, MO

NPI 1023292802 · NPPES record last updated Dec 28, 2007

Key facts

NPI
1023292802
Entity type
Organization (NPI type 2)
Primary specialty
Case Management Agency 251B00000X
Legal business name
MADISON COUNTY COUNCIL FOR DEVELOPMENTALLY DISABLED, INC.
Practice address
610 S Chamber Dr
Fredericktown, MO 63645-1742
Phone
(573) 783-3770
Fax
(573) 783-5051
NPI assigned
Dec 28, 2007
Organization subpart
No

Authorized official

Name
Mr. Clyde Avery Clifton
Title
Executive Director
Phone
(573) 783-3770

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Madison County Adult Learning Center (3 organizations share this tax ID)

Locations

610 S Chamber Dr
Fredericktown, MO 63645
Phone (573) 783-3770

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MO Yes

Addresses

Primary practice location

610 S Chamber Dr
Fredericktown, MO 63645-1742

Mailing address

PO Box 325
Fredericktown, MO 63645-0325
Phone (573) 756-8365

Other providers in Fredericktown, MO

All providers in Fredericktown, MO · Case Management Agency in Missouri

Sources for this page

Verify at the official NPI Registry.