Organization Name: | HARRISON COUNTY HANDICAPPED GROUP HOME CORPORATION |
NPI Number: | 1023141389 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN LEGAARD (MANAGER) |
Mailing Address: | 501 S 26th St Bethany |
State: | MO US |
Postal Code: | 644242182 |
Phone Number: | 6604256300 |
Fax Number: | 6604256318 |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 1336-9740 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |