Community Residence, Inc.

NPI 1033116520 - Custodial Care Facility - 311ZA0620X

NPI Details
NPI 1033116520
Enumeration Date 06/30/2005
Last Updated 10/30/2007
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name JAMES JAMES
Position PRESIDENT
Phone (417) 782-5659
Fax (417) 659-8880
Practice Location
201 FIR RD
CARL JUNCTION MO, 64834-9222, US
Phone (417) 782-5659
Fax (417) 659-8880
Business Location
312 SOLLEY DR
REAR
BALLWIN MO, 63021-5248, US
Phone (636) 394-3000
Fax (636) 394-7713
Toxanomy
Taxonomy Code 311ZA0620X
License State Missouri
License Number 029987
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According to our database, Community Residence, Inc. NPI is 1033116520, taxonomy code is 311ZA0620X and license number is 029987, license state is located at Missouri. Community Residence, Inc. physically located at 201 Fir Rd, Carl Junction MO, 64834-9222. NPI Number 1033115704 has the healthcare provider type.

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1033116520 NPI number is provided on an as is basis without warranty of any kind. 1033116520 is maintained by the National Plan & Provider Enumeration System. The contents of Community Residence, Inc. are for informational purposes only.