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Ms. Jeannie Gloria Dake
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rolla, Missouri
NPI 1144349259

Jeannie Gloria Dake is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Rolla, MO. Jeannie Gloria Dake practices in Rolla, MO. The NPI Number for Jeannie Gloria Dake is 1144349259 and holds a License No. (Missouri).

The current practice location address for Jeannie Gloria Dake is 1101 Strobach St, Rolla, MO and can be reached out via phone at 573-364-4667. You can also correspond with Jeannie Gloria Dake through the mailing address at 1101 STROBACH ST, ROLLA, MO - 65401-4243 (mailing address contact number: 573-364-4667).

Location: 1101 Strobach St, Rolla, MO, 65401-4243
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144349259
Provider Name
Jeannie Gloria Dake
Credential
Provider Entity Type
Individual
Gender
Female
Address
1101 Strobach St, Rolla, MO, 65401-4243
Phone Number
573-364-4667
Fax Number
Provider Enumeration Date
03/28/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1101 Strobach St
City
Rolla
State
Missouri
Zip
65401-4243
Phone Number
573-364-4667
Fax Number
person
Provider Business Mailing Address Details
Address
1101 Strobach St
City
Rolla
State
Missouri
Zip
65401-4243
Phone Number
573-364-4667
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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