Jody House LLC

NPI #1700901816 in Rolla, Missouri

Provider Information

NPI Number: 1700901816
Entity Type: Organization
Organization Name: Jody House LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 20, 2007
Last Updated: Jul 29, 2008

Practice Location

Address: 602 NORTH WALNUT
Address 2: 2608 BROOK
City: Rolla
State: Missouri
ZIP Code: 65401
Phone: (573) 578-2979

Authorized Official

Name: MRS. RUTH LEE RUCK
Title: OWNER
Phone: (573) 578-2979

Specialties & Taxonomy Codes

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

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