Organization · Type 2 NPI

Prime Supported Living LLC

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

NPI number 1891624409 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 Residential Treatment Facility Primary 320600000XNone listed

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1891624409

Prime Supported Living LLC's National Provider Identifier is 1891624409, issued on May 18, 2026. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Columbia, MO. The record was last updated on May 18, 2026.