Provider Demographics
NPI:1245385491
Name:PARTNERS IN YOUR COMMUNITY, INC.
Entity Type:Organization
Organization Name:PARTNERS IN YOUR COMMUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-876-5500
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:5085 EAST HIGHWAY 54
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-0268
Mailing Address - Country:US
Mailing Address - Phone:417-876-5500
Mailing Address - Fax:417-876-5575
Practice Address - Street 1:5085 E HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:EL DORADO SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64744-8589
Practice Address - Country:US
Practice Address - Phone:417-876-5500
Practice Address - Fax:417-876-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO17550246251C00000X, 251S00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities