| Organization Name: | SOUTHWEST MISSOURI OFFICE ON AGING |
| NPI Number: | 1124226089 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOROTHY K KNOWLES (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1850 W Broadway St Bolivar |
| State: | MO US |
| Postal Code: | 656131869 |
| Phone Number: | 4173262140 |
| Fax Number: | 4177778728 |
| NPI Enumeration Date: | 07/03/2007 |
| NPI Last Update Date: | 06/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 676 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |