Individual provider · Type 1 NPI
Bonnie Sue Faughn
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Poplar Bluff, MO
Practice location
2342 County Road 523
Poplar Bluff, MO 63901-8017
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.
About NPI 1407994601
Bonnie Sue Faughn's National Provider Identifier is 1407994601, issued on Feb 1, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Poplar Bluff, MO. The record was last updated on Jul 9, 2007.