Provider Demographics
NPI:1386869592
Name:MARION COUNTY SERVICES FOR THE DEVELOPMENTALLY DISABLED
Entity type:Organization
Organization Name:MARION COUNTY SERVICES FOR THE DEVELOPMENTALLY DISABLED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ARROWSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BS,CMA,
Authorized Official - Phone:573-248-1077
Mailing Address - Street 1:3175 PALMYRA ROAD
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401
Mailing Address - Country:US
Mailing Address - Phone:573-248-1077
Mailing Address - Fax:573-248-2978
Practice Address - Street 1:3175 PALMYRA ROAD
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401
Practice Address - Country:US
Practice Address - Phone:573-248-1077
Practice Address - Fax:573-248-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO15026507251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health