| NPI | 1386843621 |
|---|---|
| Doing Business As | LAKELAND GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | MOLLY JANE BOECKMANN Director Of Administrative Services 573-751-4055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2020-08-28 |