Organization · Type 2 NPI
Gracie Lane Day Hab, LLC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Koshkonong, MO
Practice location
RR 81 Box 175
Koshkonong, MO 65692-8004
Fax (417) 867-3367
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | CC03100514 (MO) |
| Respite Care | 385H00000X | CC03100514 (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 1881055812
Gracie Lane Day Hab, LLC's National Provider Identifier is 1881055812, issued on Mar 18, 2016. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Koshkonong, MO. The record was last updated on Mar 22, 2016.