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General NPI Number Information
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NPI Number | 1154045284
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Entity Type | Organization
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Legal Business Name | PIKE COUNTY SHELTERED WORKSHOP
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 900 INDEPENDENCE DR
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City | BOWLING GREEN
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State | MO
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Zip | 63334-2440
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Country | US
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Telephone | 573-324-2205
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 346
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City | BOWLING GREEN
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State | MO
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Zip | 63334-0346
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Country | US
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Telephone | 573-324-2205
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JULIE M CRODWER
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Credential |
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Telephone | 573-324-2205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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