Provider Demographics
NPI:1518198043
Name:BENTON COUNTY ADVOCATES FOR DEVELOPMENTAL DISABILITIES
Entity Type:Organization
Organization Name:BENTON COUNTY ADVOCATES FOR DEVELOPMENTAL DISABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-438-3200
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-0011
Mailing Address - Country:US
Mailing Address - Phone:660-438-3200
Mailing Address - Fax:660-438-2459
Practice Address - Street 1:1661 COMMERCIAL STREET
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355
Practice Address - Country:US
Practice Address - Phone:660-438-3200
Practice Address - Fax:660-438-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No347C00000XTransportation ServicesPrivate Vehicle