Willow Creek Group Home

NPI #1942544820 in Adrian, Missouri

Provider Information

NPI Number: 1942544820
Entity Type: Organization
Organization Name: Willow Creek Group Home
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 16, 2012
Last Updated: Nov 16, 2012

Practice Location

Address: RURAL ROUTE 2, BOX 27
City: Adrian
State: Missouri
ZIP Code: 64720
Phone: (816) 297-4256

Authorized Official

Name: MRS. JEANIE SUE STEPHENS
Title: OWNER
Phone: (816) 297-4256

Specialties & Taxonomy Codes

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

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