Provider Demographics
NPI:1750688545
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:ASST DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-665-9400
Mailing Address - Street 1:215 E MCPHERSON ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3566
Mailing Address - Country:US
Mailing Address - Phone:660-665-9400
Mailing Address - Fax:660-665-9404
Practice Address - Street 1:215 E MCPHERSON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3566
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:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)