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Mr. Charles Alden Redburn
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pomona, Missouri
NPI 1952689473

Charles Alden Redburn is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Pomona, MO. Charles Alden Redburn practices in Pomona, MO. The NPI Number for Charles Alden Redburn is 1952689473 and holds a License No. (Missouri).

The current practice location address for Charles Alden Redburn is 7050 County Road 4730, Pomona, MO and can be reached out via phone at 417-256-0016.

Location: 7050 County Road 4730, Pomona, MO, 65789-9586
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952689473
Provider Name
Charles Alden Redburn
Credential
Provider Entity Type
Individual
Gender
Male
Address
7050 County Road 4730, Pomona, MO, 65789-9586
Phone Number
417-256-0016
Fax Number
Provider Enumeration Date
08/01/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
7050 County Road 4730
City
Pomona
State
Missouri
Zip
65789-9586
Phone Number
417-256-0016
Fax Number
person
Provider Business Mailing Address Details
Address
7050 County Road 4730
City
Pomona
State
Missouri
Zip
65789-9586
Phone Number
417-256-0016
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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