Kings Vista LLC

NPI #1639347750 in Marshall, Missouri

Provider Information

NPI Number: 1639347750
Entity Type: Organization
Organization Name: Kings Vista LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 11, 2008
Last Updated: Feb 11, 2008

Practice Location

Address: 628 E HIGH ST
City: Marshall
State: Missouri
ZIP Code: 65340-1294
Phone: (660) 886-2975

Authorized Official

Name: ROBERT T KING
Title: ADMINISTRATOR
Phone: (660) 886-2975

Specialties & Taxonomy Codes

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

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