Boone Supported Living, LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hannibal, MO
NPI 1568680403 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1568680403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- BOONE SUPPORTED LIVING, LLC
- Practice address
- 5 Marsh Cir
Hannibal, MO 63401-2479 - Phone
- (573) 406-8010
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Julie Walden
- Title
- Member
- Phone
- (573) 406-8010
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
5 Marsh Cir
Hannibal, MO 63401-2479
Mailing address
5 Marsh Cir
Hannibal, MO 63401-2479
Phone (573) 406-8010
Other providers in Hannibal, MO
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- Sarah Ann Boland
- Micheal Steven Boling
- Misty D Bowen
- Bowling Green Arthritis & Rheumatology Clinic P C
- Carrol Leann Boxerman
- Nicole Suzanne Bradshaw
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All providers in Hannibal, MO · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.