Organization · Type 2 NPI

Prime Supported Living LLC

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

NPI number 1891624326 Active

Practice location

117 Walton Heath Ct
Columbia, MO 65201-5822

Call (619) 451-1491 Map

Specialties and licenses

TaxonomyCodeLicense
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 1891624326

Prime Supported Living LLC's National Provider Identifier is 1891624326, issued on May 19, 2026. 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 May 19, 2026.