Healthcare Provider Details

I. General information

NPI: 1497337281
Provider Name (Legal Business Name): STONE COUNTY DEVELOPMENTAL DISABILITY BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21016 MAIN ST
REEDS SPRING MO
65737-9771
US

IV. Provider business mailing address

PO BOX 2383
BRANSON WEST MO
65737-2383
US

V. Phone/Fax

Practice location:
  • Phone: 417-272-0444
  • Fax: 417-272-0665
Mailing address:
  • Phone: 417-272-0444
  • Fax: 417-272-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LADELLA THOMAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 417-272-0444