COMMUNITY RESIDENCE INC. NPI 1518964006

NPI Information

  • NPI: 1518964006
  • Provider Name: COMMUNITY RESIDENCE, INC.
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Doing Business As: SALEM RESIDENTIAL CARE
  • CLIA Number: 26D0906274
  • Address: 1207 E ROOSEVELT ST
    SALEM, MO
    ZIP 65560
  • Phone: (573) 729-9449

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NPI Details

COMMUNITY RESIDENCE, INC. is an adult care home custodial care facility in Salem, MO. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. COMMUNITY RESIDENCE, INC. NPI is 1518964006. The provider is registered as an organization entity type.
The provider Is Doing Business As Salem Residential Care.

The provider's business location address is:

1207 E ROOSEVELT ST
SALEM, MO
ZIP 65560-676
Phone: (573) 729-9449
Fax: (573) 729-8719

The provider's authorized official is James Giardina .
The authorized official title is President and has the following contact phone number (636) 394-3000.

The CLIA number assigned to this NPI record is 26D0906274 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 8/22/2020.

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 License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care Home030959MISSOURIYes

What is NPI?

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This page was last updated on: 11/21/2025

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