Individual provider · Type 1 NPI
Glenna Smith
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Newburg, MO
Practice location
24752 Clementine Outer Rd
Newburg, MO 65550-9048
Mailing address
PO Box 347
Newburg, MO 65550-0347
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 5972-9429 (MO) |
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 1619091741
Glenna Smith's National Provider Identifier is 1619091741, issued on Mar 16, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Newburg, MO. The record was last updated on Feb 17, 2010.