Organization · Type 2 NPI

Green Maxville Supportive Living LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Columbia, MO

NPI number 1235511692 Active

Practice location

101 E Alhambra Dr
Columbia, MO 65203-3763

Call (573) 864-9743 Map

Fax (573) 874-1723

Mailing address

5900 Galli Ln
Collinsville, IL 62234-5836

Specialties and licenses

TaxonomyCodeLicense
Community/Behavioral Health Agency 251S00000XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1235511692

Green Maxville Supportive Living LLC's National Provider Identifier is 1235511692, issued on Jun 22, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Columbia, MO. The record was last updated on Jun 22, 2015.