Provider Demographics
NPI:1366571333
Name:DUNKLIN DAY ACTIVITY CENTER
Entity type:Organization
Organization Name:DUNKLIN DAY ACTIVITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:573-888-1727
Mailing Address - Street 1:320 KENNETT ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-3018
Mailing Address - Country:US
Mailing Address - Phone:573-888-1727
Mailing Address - Fax:573-888-4557
Practice Address - Street 1:320 KENNETT ST
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-3018
Practice Address - Country:US
Practice Address - Phone:573-888-1727
Practice Address - Fax:573-888-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services