Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Green Maxville Supportive Living LLC

Organization Community/Behavioral Health Agency · NPI 1235511692

Green Maxville Supportive Living LLC is a Community/Behavioral Health Agency in Columbia, Missouri. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

101 E Alhambra Dr
Columbia, MO 65203-3763
Phone: (573) 864-9743
Fax: (573) 874-1723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X
Community/Behavioral Health Agency Taxonomy 251S00000X

Record details

NPI number1235511692
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dale Maxville — President/Owner · (573) 864-9743
NPI enumeratedJune 22, 2015
Last updated in NPPESJune 22, 2015
Mailing address5900 Galli Ln, Collinsville, IL 62234-5836

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