COMMUNITY RESIDENCE, INC. is an adult care home custodial care facility in Licking, 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 1275530776. The provider is registered as an organization entity type.
The provider Is Doing Business As Licking Residential Care.
The provider's business location address is:
225 W HIGHWAY 32
LICKING, MO
ZIP 65542-832
Phone: (573) 674-2207
Fax: (573) 674-2239
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 26D1038551 - other - rcf ii with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/30/2005 and was last updated on 6/13/2008.