Individual provider · Type 1 NPI
Shannon Dee Wassam
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Smithton, MO
Practice location
308 E Smith St
Smithton, MO 65350-1079
Fax (660) 343-5871
Mailing address
PO Box 513, 308 E Smith
Smithton, MO 65350-0513
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.
Another provider at this address
About NPI 1356465033
Shannon Dee Wassam's National Provider Identifier is 1356465033, issued on Mar 19, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Smithton, MO. The record was last updated on Oct 7, 2014.