Provider Demographics
NPI:1508180878
Name:LIVINGSTON CO. R-III
Entity Type:Organization
Organization Name:LIVINGSTON CO. R-III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-639-3135
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:205 WAITE STREET
Mailing Address - City:CHULA
Mailing Address - State:MO
Mailing Address - Zip Code:64635-0040
Mailing Address - Country:US
Mailing Address - Phone:660-639-3135
Mailing Address - Fax:660-393-2171
Practice Address - Street 1:205 WAITE ST
Practice Address - Street 2:
Practice Address - City:CHULA
Practice Address - State:MO
Practice Address - Zip Code:64635-8273
Practice Address - Country:US
Practice Address - Phone:660-639-3135
Practice Address - Fax:660-393-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty