ANNA DODSON HOME LLC NPI 1902369663

NPI Information

ANNA DODSON HOME LLC is a community based residential treatment facility mental illness in Farmington, MO. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. ANNA DODSON HOME LLC NPI is 1902369663. The provider is registered as an organization entity type.

The provider's business location address is:

4616 HWY D
FARMINGTON, MO
ZIP 63640-241
Phone: (573) 756-5530
Fax: (573) 756-5530

The provider's authorized official is Penny Mcdowell .
The authorized official title is Main Member/administrator and has the following contact phone number (573) 631-3644.

The CLIA number assigned to this NPI record is 26D0922337 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/10/2019 and was last updated on 4/10/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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