Organization
COLE COUNTY RESIDENTIAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM CASEY (EXECUTIVE DIRECTOR)
(573) 634-4555
Entity
Organization
Contact information
Practice address
1800 TANNER BRIDGE RD, JEFFERSON CITY, MO 65101-2848
(573) 634-4555
Mailing address
1908 BOGGS CREEK RD, JEFFERSON CITY, MO 65101-5580
(573) 634-4555
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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