Callaway County Special Services

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

NPI 1992932354 · NPPES record last updated Jun 12, 2009

Key facts

NPI
1992932354
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
N00859770 (MO)
Legal business name
CALLAWAY COUNTY SPECIAL SERVICES
Practice address
911 S Business 54
Fulton, MO 65251-1406
Phone
(573) 642-1792
Fax
(573) 642-2415
NPI assigned
Jun 12, 2009
Organization subpart
No

Authorized official

Name
Mr. Charles E. Snow, M. S.
Title
Executive Director
Phone
(573) 642-1792

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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
Callaway County Special Services (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X N00859770 MO Yes

Addresses

Primary practice location

911 S Business 54
Fulton, MO 65251-1406

Mailing address

911 S Business 54
Fulton, MO 65251-1406
Phone (573) 642-1792

Other identifiers

IdentifierTypeStateIssuer
853013803MedicaidMO
853563906MedicaidMO
852944305MedicaidMO

Other providers in Fulton, MO

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

Sources for this page

Verify at the official NPI Registry.