| NPI | 1518291418 |
|---|---|
| Doing Business As | JUDEVINE CENTER FOR AUTISM |
| Entity Type | Organization |
| Authorized Contact | REBECCA BLACKWELL President/Director 800-780-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO ER019910064) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X (Licence: MO ER019910064) | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2015-01-07 |