Organization · Type 2 NPI

Wyatt's Dream Center, LLC

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

NPI number 1427693092 Active

Practice location

205 State Highway Aa
Sikeston, MO 63801-5303

Call (573) 475-8025 Map

Fax (573) 475-8026

Mailing address

106 Dacus Dr
Sikeston, MO 63801-9013

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

Wyatt's Dream CenterIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Sikeston, MO NPI 1942851399

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NPI record

NPI: 1427693092
Entity type: Organization (Type 2)
Issued: Nov 7, 2019
Last updated: Nov 7, 2019
Status: Active

Other names

Wyatt's Dream Center · doing business as
Wyatt's Dream Center, LLC · former legal business name

Authorized official

Melissa A Stewart
Owner/administrator
(573) 380-8035

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1427693092

Wyatt's Dream Center, LLC's National Provider Identifier is 1427693092, issued on Nov 7, 2019. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Sikeston, MO. The record was last updated on Nov 7, 2019.