CLARK SUPPORTED LIVING NPI 1326514381

NPI Information

NPI: 1326514381
Provider Name: CLARK SUPPORTED LIVING
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
303 MACAW DR
COLUMBIA, MO
ZIP 65202
Phone: (773) 332-6106
Get Directions

CLARK SUPPORTED LIVING is a residential treatment facility, intellectual and/or developmental disabilities in Columbia, MO. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. CLARK SUPPORTED LIVING NPI is 1326514381. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

303 MACAW DR
COLUMBIA, MO
ZIP 65202
Phone: (773) 332-6106

The provider's authorized official is Zondra D Clark .
The authorized official title is Executive Director and has the following contact phone number (773) 332-6106.

The enumeration date for this NPI number is 10/17/2018 and was last updated on 10/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	163WC1500X	Registered Nurse	Community Health	No
2	174200000X	Meals		No
3	251B00000X	Case Management		No
4	251J00000X	Nursing Care		No
5	251S00000X	Community/Behavioral Health		No
6	251X00000X	Supports Brokerage		No
7	253Z00000X	In Home Supportive Care		No
8	261QA0600X	Clinic/Center	Adult Day Care	No
9	261QD1600X	Clinic/Center	Developmental Disabilities	No
10	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		No
11	385H00000X	Respite Care		No
12	385HR2055X	Respite Care	Respite Care, Mental Illness, Child	No
13	385HR2060X	Respite Care	Respite Care, Intellectual and/or Developmental Disabilities	No
14	385HR2065X	Respite Care	Respite Care, Physical Disabilities, Child	No
15	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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