Home Care Isl, LLC
NPI #1164799417 in Fredericktown, Missouri
Provider Information
- NPI Number
- 1164799417
- Entity Type
- Organization
- Organization Name
- Home Care Isl, LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Nov 30, 2011
- Last Updated
- Nov 30, 2011
Practice Location
- Address
- 1018 JOHNSON STREET
- City
- Fredericktown
- State
- Missouri
- ZIP Code
- 63645-0467
- Phone
- (573) 631-1456
Authorized Official
- Name
- SUSAN STOTZ, RN, QDDP
- Title
- DIRECTOR
- Phone
- (573) 631-1456
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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