Provider Demographics
NPI:1295925725
Name:FOCUS ONE RESIDENTIAL SERVICES
Entity type:Organization
Organization Name:FOCUS ONE RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUDREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-778-1776
Mailing Address - Street 1:RR 1 BOX 1550
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:MO
Mailing Address - Zip Code:65606-9789
Mailing Address - Country:US
Mailing Address - Phone:417-778-1776
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 1550
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:MO
Practice Address - Zip Code:65606-9789
Practice Address - Country:US
Practice Address - Phone:417-778-1776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-10-13
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