Lasting Impressions Group Home

NPI #1235349614 in Smithton, Missouri

Provider Information

NPI Number: 1235349614
Entity Type: Organization
Organization Name: Lasting Impressions Group Home
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 23, 2007
Last Updated: Oct 7, 2014

Practice Location

Address: 308 E SMITH ST
City: Smithton
State: Missouri
ZIP Code: 65350-1079
Phone: (660) 343-3681

Authorized Official

Name: SHANNON DEE WASSAM
Title: DIRECTOR
Phone: (660) 343-3681

Specialties & Taxonomy Codes

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

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