TRI-COUNTY COMMUNITY INDIVIDUALIZED SUPPORTED LIVING, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Portageville, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. TRI-COUNTY COMMUNITY INDIVIDUALIZED SUPPORTED LIVING, LLC NPI is 1700545670. The provider is registered as an organization entity type.
The provider's business location address is:
46 E STATE HIGHWAY 162
PORTAGEVILLE, MO
ZIP 63873-177
Phone: (573) 391-8031
Fax: (573) 391-8050
The provider's authorized official is Ladonna Jean Williams .
The authorized official title is Owner/provider and has the following contact phone number (573) 391-8031.
The enumeration date for this NPI number is 12/8/2021 and was last updated on 12/8/2021.