Organization · Type 2 NPI

Jesse R. Kirchhoff

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

NPI number 1629468558 Active

Practice location

113 Jaycee Dr, Suite 108
Jefferson City, MO 65109-1094

Call (573) 635-2708 Map

Fax (866) 468-2970

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone 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.

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About NPI 1629468558

Jesse R. Kirchhoff's National Provider Identifier is 1629468558, issued on Jan 30, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Jefferson City, MO. The record was last updated on Jan 30, 2015.