Willow Creek Isl, LLC

NPI #1871897017 in Adrian, Missouri

Provider Information

NPI Number: 1871897017
Entity Type: Organization
Organization Name: Willow Creek Isl, LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 3, 2011
Last Updated: Jan 28, 2022

Practice Location

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

Authorized Official

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

Specialties & Taxonomy Codes

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

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