Provider Demographics
NPI:1013206986
Name:COMMUNITY LIVING, INC.
Entity Type:Organization
Organization Name:COMMUNITY LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-970-2800
Mailing Address - Street 1:1040 SAINT PETERS HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5259
Mailing Address - Country:US
Mailing Address - Phone:636-970-2800
Mailing Address - Fax:636-970-2810
Practice Address - Street 1:1040 SAINT PETERS HOWELL RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5259
Practice Address - Country:US
Practice Address - Phone:636-970-2800
Practice Address - Fax:636-970-2810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO8002252Medicaid