Kelley L Yeokum

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Freeman, MO

NPI 1104967637 · NPPES record last updated Jun 30, 2008

Key facts

NPI
1104967637
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
62819415 (MO)
Legal business name
KELLEY L YEOKUM
Practice address
27421 S State Route 2
Freeman, MO 64746-7102
Phone
(816) 250-2398
Fax
(816) 250-2398
NPI assigned
Feb 9, 2007
Organization subpart
No

Authorized official

Name
Mrs. Kelley Lynn Yeokum, MSE
Title
Sole Proprietor
Phone
(816) 419-7106

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 62819415 MO Yes

Addresses

Primary practice location

27421 S State Route 2
Freeman, MO 64746-7102

Mailing address

27421 S State Route 2
Freeman, MO 64746-7102
Phone (816) 250-2398

Sources for this page

Verify at the official NPI Registry.