Provider Demographics
NPI:1427379593
Name:ADAIR COUNTY SB40 DEVELOPMENTAL DISABILITY BOARD
Entity Type:Organization
Organization Name:ADAIR COUNTY SB40 DEVELOPMENTAL DISABILITY BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WOHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-665-9400
Mailing Address - Street 1:1107 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-5355
Mailing Address - Country:US
Mailing Address - Phone:660-665-9400
Mailing Address - Fax:660-665-9404
Practice Address - Street 1:1107 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-5355
Practice Address - Country:US
Practice Address - Phone:660-665-9400
Practice Address - Fax:660-665-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management