Organization
OSAGE COUNTY COMMUNITY LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY J MCCUSKEY (EXECUTIVE DIRECTOR)
(573) 897-2991
Entity
Organization
Contact information
Practice address
1006 E JEFFERSON ST, LINN, MO 65051-9710
(573) 897-2991
(573) 897-4763
Mailing address
PO BOX 913, 1006 EAST JEFFERSON ST, LINN, MO 65051-0913
(573) 897-2991
(573) 897-4763
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265433409
—
MO
Enumeration date
10/23/2006
Last updated
10/26/2016
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