Provider Demographics
NPI:1730219833
Name:EASTWOOD ACRES INC
Entity type:Organization
Organization Name:EASTWOOD ACRES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-886-4113
Mailing Address - Street 1:PO BOX 606
Mailing Address - Street 2:855 E EASTWOOD
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-1541
Mailing Address - Country:US
Mailing Address - Phone:660-886-4113
Mailing Address - Fax:660-886-4113
Practice Address - Street 1:855 EAST EASTWOOD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-1541
Practice Address - Country:US
Practice Address - Phone:660-886-4113
Practice Address - Fax:660-886-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities