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

Pettis County Assisted Living, LLC

Organization Assisted Living Facility · NPI 1568821965

Pettis County Assisted Living, LLC is an Assisted Living Facility in Sedalia, Missouri. Registered with an NPI since 2016.

In the registry since
2016
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

3017 Brooking Park Ave
Sedalia, MO 65301-9327
Phone: (660) 827-3222
Fax: (660) 829-2217
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X
Assisted Living Facility (Mental Illness) Taxonomy 3104A0625X

Record details

NPI number1568821965
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Destefane — President · (314) 543-3800
NPI enumeratedFebruary 15, 2016
Last updated in NPPESFebruary 15, 2016
Mailing address1869 Craig Park Ct, Saint Louis, MO 63146-4122

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