Provider Demographics
NPI:1295893089
Name:GRUNDY COUNTY ASSOCIATION FOR HANDICAPPED CITIZENS
Entity type:Organization
Organization Name:GRUNDY COUNTY ASSOCIATION FOR HANDICAPPED CITIZENS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-359-2851
Mailing Address - Street 1:2600 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-3059
Mailing Address - Country:US
Mailing Address - Phone:660-359-6655
Mailing Address - Fax:660-359-6098
Practice Address - Street 1:2600 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-3059
Practice Address - Country:US
Practice Address - Phone:660-359-6655
Practice Address - Fax:660-359-6098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1605-9532251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services