Lakeshores Residential Care Facility

NPI #1215055371 in Urbana, Missouri

Provider Information

NPI Number: 1215055371
Entity Type: Organization
Organization Name: Lakeshores Residential Care Facility
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 27, 2007
Last Updated: Jun 9, 2020

Practice Location

Address: 27 HOPPER TRL
City: Urbana
State: Missouri
ZIP Code: 65767-9234
Phone: (417) 722-4416

Authorized Official

Name: MISS SANDRA RUTHERFORD
Title: MANAGER
Phone: (417) 722-4416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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