Provider Demographics
NPI:1003186156
Name:DEVELOPMENTAL DISABILITIES RESOURCE BOARD OF CLAY COUNTY
Entity Type:Organization
Organization Name:DEVELOPMENTAL DISABILITIES RESOURCE BOARD OF CLAY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CHIEF EXECUTIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-826-4400
Mailing Address - Street 1:1500 EWING DR
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2396
Mailing Address - Country:US
Mailing Address - Phone:660-826-4400
Mailing Address - Fax:866-495-6424
Practice Address - Street 1:920 S. KENT ST
Practice Address - Street 2:SUITE B
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068
Practice Address - Country:US
Practice Address - Phone:660-826-4400
Practice Address - Fax:866-495-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management