Tri-County Community Individualized Supported Living, LLC
Tri-County Community Individualized Supported Living, LLC is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portageville, Missouri. Registered with an NPI since 2021.
- In the registry since
- 2021
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
46 E State Highway 162Portageville, MO 63873-9177
Phone: (573) 391-8031
Fax: (573) 391-8050
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
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 |
|---|
Record details
| NPI number | 1700545670 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ladonna Williams — Owner/Provider · (573) 391-8031 |
| NPI enumerated | December 8, 2021 |
| Last updated in NPPES | December 8, 2021 |
| Certification date | December 8, 2021 |
| Mailing address | 46 E State Highway 162, Portageville, MO 63873-9177 |