Provider Demographics
NPI:1447372826
Name:DANIELS FAMILY HOME II
Entity type:Organization
Organization Name:DANIELS FAMILY HOME II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:NMI
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:660-438-5704
Mailing Address - Street 1:29318 HIGHWAY MM
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-7091
Mailing Address - Country:US
Mailing Address - Phone:660-438-5704
Mailing Address - Fax:
Practice Address - Street 1:29318 HIGHWAY MM
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355-7091
Practice Address - Country:US
Practice Address - Phone:660-438-5704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities