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General NPI Number Information
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NPI Number | 1417243130
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Entity Type | Organization
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Legal Business Name | WARREN COUNTY DEVELOPMENTAL DISABILITIES BOARD
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 105 E BOONESLICK RD
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City | WARRENTON
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State | MO
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Zip | 63383-2003
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Country | US
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Telephone | 636-456-7518
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Fax | 636-456-2303
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Provider Business Mailing Address
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Address Line | 105 E BOONESLICK RD
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City | WARRENTON
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State | MO
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Zip | 63383-2003
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Country | US
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Telephone | 636-456-7518
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Fax | 636-456-2303
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Authorized Official
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Title or Position | SB 40 DIRECTOR
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Name | MS. ANITA M CONTRERAS
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Credential |
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Telephone | 636-456-7518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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