Individual provider · Type 1 NPI
Nicholas Spencer, OTR/L
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Gatewood, MO
Practice location
3570 Ripley EE-2
Gatewood, MO 63942-9034
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 2018031484 (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 1740743459
Nicholas Spencer, OTR/L's National Provider Identifier is 1740743459, issued on Apr 9, 2019. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Gatewood, MO. The record was last updated on Jun 4, 2024.