Azare

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bolivar, MO

NPI 1508915299 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1508915299
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
14209362 (MO)
Legal business name
AZARE
Practice address
4243 Highway D
Bolivar, MO 65613-9302
Phone
(417) 777-4948
NPI assigned
Jan 10, 2007
Organization subpart
No

Authorized official

Name
Linda L Mashburn
Title
Owner
Phone
(417) 777-4948

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 14209362 MO Yes

Addresses

Primary practice location

4243 Highway D
Bolivar, MO 65613-9302

Mailing address

4243 Highway D
Bolivar, MO 65613-9302
Phone (417) 777-4948

Other providers in Bolivar, MO

All providers in Bolivar, MO · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

Sources for this page

Verify at the official NPI Registry.