| NPI | 1245376524 |
|---|---|
| Doing Business As | PARK PLACE GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | NICKI G. SAMSON Executive Director 660-736-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO MW 011034) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |