Licking Residential Care

LBN: Community Residence, Inc.
Licking Residential Care is an health care organization with primary practice located at 225 W Highway 32 , Licking MO 65542-9832. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Community Residence, Inc. can be contacted via phone (573) 674-2207, or through Giardina, James via phone (636) 394-3000.

Contact Information

Primary practice address
225 W Highway 32 Licking MO 65542-9832
Phone: (573) 674-2207
Fax: (573) 674-2239
Website:
Map and Directions
Authorized official contact:
Name: Giardina, James
Phone: (636) 394-3000

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X 030734 Missouri

Profile Details

NPI number 1275530776
LBN Legal business name Community Residence, Inc.
DBA Doing business as Licking Residential Care
Authorized official Giardina, James
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 30th, 2005
Last updated Jun 13th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275530776 NPPES
Missouri MEDICAID 266178706

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