Provider Demographics
NPI:1487945689
Name:TRI-COUNTY ADULT DAY CARE
Entity type:Organization
Organization Name:TRI-COUNTY ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WARD
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:417-859-7746
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-0256
Mailing Address - Country:US
Mailing Address - Phone:417-859-7746
Mailing Address - Fax:417-859-7411
Practice Address - Street 1:541 W HUBBLE DR
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MO
Practice Address - Zip Code:65706-1532
Practice Address - Country:US
Practice Address - Phone:417-859-7746
Practice Address - Fax:417-859-7411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO941261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care