Community Residential Supportive Living

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

COMMUNITY RESIDENTIAL SUPPORTIVE LIVING

Practice address

1026 Villa St.Cyr
Saint Louis, MO 63137

Phone

(314) 869-1977

Fax

(314) 869-1977

NPI assigned

Apr 2, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Monica Gillespie

Title

Direct Support Professional

Phone

(314) 869-1977

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1295907921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 VILLA ST.CYR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63137",
            "telephone_number": "314-869-1977",
            "fax_number": "314-869-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 VILLA ST.CYR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63137",
            "telephone_number": "314-869-1977",
            "fax_number": "314-869-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESIDENTIAL SUPPORTIVE LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "GILLESPIE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "DIRECT SUPPORT PROFESSIONAL",
        "authorized_official_telephone_number": "314-869-1977"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Health and Immunization Services
• Community Health-in-Partnership Services
• Community Integration Services, Inc.
• Community Orthopedics & Sports Medicine, PC
• Community Rehab of Greenville Inc
• Community Response
• Community Supportive Services
• Community Wellness Counseling
• Gilbert Matthew Comola, AGNP
• Kelly E Compas, AGACNP-BC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.