Provider Demographics
NPI:1386781433
Name:NORTHWEST MISSOURI LEARNING CENTER, INC.
Entity type:Organization
Organization Name:NORTHWEST MISSOURI LEARNING CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRUEBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-736-5523
Mailing Address - Street 1:302 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:TARKIO
Mailing Address - State:MO
Mailing Address - Zip Code:64491-1342
Mailing Address - Country:US
Mailing Address - Phone:660-736-5523
Mailing Address - Fax:660-736-4884
Practice Address - Street 1:805 PINE ST
Practice Address - Street 2:
Practice Address - City:TARKIO
Practice Address - State:MO
Practice Address - Zip Code:64491-1639
Practice Address - Country:US
Practice Address - Phone:660-736-5523
Practice Address - Fax:660-736-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities