Willow Creek Group Home, Inc.

NPI #1922141068 in Adrian, Missouri

Provider Information

NPI Number: 1922141068
Entity Type: Organization
Organization Name: Willow Creek Group Home, Inc.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 15, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: RR 2 BOX 27
City: Adrian
State: Missouri
ZIP Code: 64720-9587
Phone: (816) 297-8956

Authorized Official

Name: MRS. JEANIE SUE STEPHENS
Title: OWNER
Phone: (816) 297-8956

Specialties & Taxonomy Codes

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

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