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Jody House Llc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Rolla, Missouri
NPI 1700901816

Jody House Llc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Rolla, MO. Jody House Llc practices in Rolla, MO. The NPI Number for Jody House Llc is 1700901816 and holds a License No. 265068694 (Missouri).

The current practice location address for Jody House Llc is 602 North Walnut, Rolla, MO and can be reached out via phone at 573-578-2979 and via fax at 572-364-4778.

Location: 602 North Walnut, Rolla, MO, 65401-3368
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700901816
Provider Name
Jody House Llc
Credential
Provider Entity Type
Organization
Address
602 North Walnut, Rolla, MO, 65401-3368
Phone Number
573-578-2979
Fax Number
572-364-4778
Provider Enumeration Date
03/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
856095401 05 MO
institution
Provider Business Practice Location Address Details
Address
602 North Walnut
City
Rolla
State
Missouri
Zip
65401
Phone Number
573-578-2979
Fax Number
572-364-4778
person
Provider Business Mailing Address Details
Address
602 North Walnut
City
Rolla
State
Missouri
Zip
65401
Phone Number
573-578-2979
Fax Number
572-364-4778
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
265068694 (Missouri)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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