Provider Demographics
NPI:1497337281
Name:STONE COUNTY DEVELOPMENTAL DISABILITY BOARD
Entity Type:Organization
Organization Name:STONE COUNTY DEVELOPMENTAL DISABILITY BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LADELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-272-0444
Mailing Address - Street 1:PO BOX 2383
Mailing Address - Street 2:
Mailing Address - City:BRANSON WEST
Mailing Address - State:MO
Mailing Address - Zip Code:65737-2383
Mailing Address - Country:US
Mailing Address - Phone:417-272-0444
Mailing Address - Fax:417-272-0665
Practice Address - Street 1:21016 MAIN ST
Practice Address - Street 2:
Practice Address - City:REEDS SPRING
Practice Address - State:MO
Practice Address - Zip Code:65737-9771
Practice Address - Country:US
Practice Address - Phone:417-272-0444
Practice Address - Fax:417-272-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services