Diana'S Boarding Home 2 Inc
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Marble Hill, MO
NPI 1285227397 · NPPES record last updated Feb 19, 2021
Key facts
- NPI
- 1285227397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- DIANA'S BOARDING HOME 2 INC
- Practice address
- 4677 State Hwy M
Marble Hill, MO 63764-9408 - Phone
- (573) 238-3344
- Fax
- (573) 238-3361
- NPI assigned
- Feb 19, 2021
- Organization subpart
- No
Authorized official
- Name
- Mr. Terry Dustin Wagner
- Title
- Owner/President
- Phone
- (573) 238-3344
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Diana'S Boarding Home 2 Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
4677 State Hwy M
Marble Hill, MO 63764-9408
Mailing address
HC 64 Box 4677
Marble Hill, MO 63764-9408
Phone (573) 238-3344
Other providers in Marble Hill, MO
- Cross Trails Medical Center
- Cross Trails Medical Center
- Crosstree Healthcare the Ranch,LLC
- Terry Lynn Davis
- Diana'S Boarding Home 1, Inc
- Diana'S Boarding Home 2 Inc.
- Diana'S Boarding Home, Inc
- Diana'S Boarding Home, Inc
- Dianas Boarding Home Inc
- David Lee Downey Jr.
All providers in Marble Hill, MO · Mental Illness Community Based Residential Treatment Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.