Organization · Type 2 NPI
Community Residence, Inc.
Adult Care Home Facility · Boss, MO
NPI number
1679570170
Active
Practice location
32 Highway
Boss, MO 65440
Fax (573) 626-4611
Mailing address
312 Solley Dr, Rear
Ballwin, MO 63021-5248
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | 030558 (MO) |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1679570170
Community Residence, Inc.'s National Provider Identifier is 1679570170, issued on Jun 30, 2005. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Boss, MO. The record was last updated on Aug 22, 2020.