Organization · Type 2 NPI

Southeast Missouri State University

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Cape Girardeau, MO

NPI number 1295014470 Active

Practice location

2100 Themis St Ste 103C
Cape Girardeau, MO 63701-5124

Fax (573) 290-5142

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

2 other providers at this address

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Cape Girardeau

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NPI record

NPI: 1295014470
Entity type: Organization (Type 2)
Issued: Aug 5, 2011
Last updated: Feb 15, 2019
Status: Active

Other names

<unavail>
Horizons Enrichment Center · doing business as
Horizons Enrichment Center · doing business as

Authorized official

Mrs. Tracy Lynne Owens, BSPA
Director
(573) 290-5115

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About NPI 1295014470

Southeast Missouri State University's National Provider Identifier is 1295014470, issued on Aug 5, 2011. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Cape Girardeau, MO. The record was last updated on Feb 15, 2019.