Beacon Way 111

NPI #1033399407 in Albany, Missouri

Provider Information

NPI Number: 1033399407
Entity Type: Organization
Organization Name: Beacon Way 111
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 13, 2007
Last Updated: Nov 13, 2007

Practice Location

Address: 3411 STATE HIGHWAY 85
City: Albany
State: Missouri
ZIP Code: 64402-8335
Phone: (660) 726-3415

Authorized Official

Name: MARCY S SORENSEN
Title: DIRECTOR
Phone: (660) 448-3097

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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