Pulaski County Group Home

NPI #1356462022 in Crocker, Missouri

Provider Information

NPI Number: 1356462022
Entity Type: Organization
Organization Name: Pulaski County Group Home
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 2, 2007
Last Updated: Feb 17, 2010

Practice Location

Address: 307 KEETH ROAD
City: Crocker
State: Missouri
ZIP Code: 65452
Phone: (573) 736-5603

Authorized Official

Name: MRS. BOBBIE JEAN MORRIS
Title: ADMINISTRATOR
Phone: (573) 736-5603

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Day Training, Developmentally Disabled Services	251C00000X
Respite Care	385H00000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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