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Nicholas Spencer, OTR/L
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Gatewood, Missouri
NPI 1740743459

Nicholas Spencer is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Gatewood, MO. Nicholas Spencer practices in Gatewood, MO and has the professional credentials of OTR/L. The NPI Number for Nicholas Spencer is 1740743459 and holds a License No. 2018031484 (Missouri).

The current practice location address for Nicholas Spencer is Rr 9 Box 1102, Gatewood, MO and can be reached out via phone at 573-255-3347.

Location: Rr 9 Box 1102, Gatewood, MO, 63942-9034
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740743459
Provider Name
Nicholas Spencer
Credential
OTR/L
Provider Entity Type
Individual
Gender
Male
Address
Rr 9 Box 1102, Gatewood, MO, 63942-9034
Phone Number
573-255-3347
Fax Number
Provider Enumeration Date
04/09/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
Rr 9 Box 1102
City
Gatewood
State
Missouri
Zip
63942-9034
Phone Number
573-255-3347
Fax Number
person
Provider Business Mailing Address Details
Address
Rr 9 Box 1102
City
Gatewood
State
Missouri
Zip
63942-9034
Phone Number
573-255-3347
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.
2018031484 (Missouri)
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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