MEDICARE: DANIEL OPARA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1477741247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL OPARA

Provider Business Mailing Address
First Line	:	5306 SCRUGGS STATION RD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-6437
Country	:	US
Telephone Number	:	573-353-7636
Fax Number	:

Provider Business Practice Location Address
First Line	:	5306 SCRUGGS STATION RD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-6437
Country	:	US
Telephone Number	:	573-353-7636
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DANIEL C OPARA
Credential	:
Telephone Number	:	573-353-7636

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	06/23/2008

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Directions to “DANIEL OPARA ” Practice Location

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