NPI:
1730219973
Provider Name:
TDIII,INC
Doing Business As: CRANE RESIDENTIAL CARE HOME
Classification:
Assisted Living Facility - 3104A0625X
Entity Type:
Organization
Specialization: Assisted Living, Mental Illness
CLIA Number: 26D0957816
Address:
102 E LILLIAN AVE
CRANE, MO
ZIP 65633
Phone:
(417) 723-5900
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TDIII,INC is an assisted living and mental illness assisted living facility in Crane, MO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. TDIII,INC NPI is 1730219973. The provider is registered as an organization entity type.
The provider Is Doing Business As Crane Residential Care Home.
The provider's business location address is:
102 E LILLIAN AVE
CRANE, MO
ZIP 65633-103
Phone: (417) 723-5900
Fax: (417) 723-8559
The provider's authorized official is Troy Hall Davidson .
The authorized official title is Ceo and has the following contact phone number (417) 890-8172.
The CLIA number assigned to this NPI record is 26D0957816 - other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/6/2007 and was last updated on 8/22/2020.