Willow Creek Isl

NPI #1326261595 in Adrian, Missouri

Provider Information

NPI Number: 1326261595
Entity Type: Organization
Organization Name: Willow Creek Isl
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 10, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: RR 2 BOX 27
City: Adrian
State: Missouri
ZIP Code: 64720-9587
Phone: (816) 297-2833

Authorized Official

Name: MRS. JEANIE SUE STEPHENS
Title: OWNER
Phone: (816) 297-8956

Specialties & Taxonomy Codes

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

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