Provider Demographics
NPI:1457855918
Name:REYNOLDS COUNTY SHELTERED WORKSHOP, INC.
Entity Type:Organization
Organization Name:REYNOLDS COUNTY SHELTERED WORKSHOP, INC.
Other - Org Name:MULTI-COUNTY T.C.M.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-689-2213
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:BUNKER
Mailing Address - State:MO
Mailing Address - Zip Code:63629-0127
Mailing Address - Country:US
Mailing Address - Phone:573-689-2213
Mailing Address - Fax:573-689-2214
Practice Address - Street 1:133 HIGHWAY 72 E
Practice Address - Street 2:
Practice Address - City:BUNKER
Practice Address - State:MO
Practice Address - Zip Code:63629-8196
Practice Address - Country:US
Practice Address - Phone:573-689-2213
Practice Address - Fax:573-689-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management