Willow Creek Isl, LLC

NPI #1538281019 in Adrian, Missouri

Provider Information

NPI Number: 1538281019
Entity Type: Organization
Organization Name: Willow Creek Isl, LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 4, 2007
Last Updated: Dec 3, 2021

Practice Location

Address: 1008 EDITH AVE.
City: Adrian
State: Missouri
ZIP Code: 64720
Phone: (816) 225-8214

Authorized Official

Name: CHRISTIAN DENISON
Title: OWNER
Phone: (816) 225-8214

Specialties & Taxonomy Codes

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

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