Organization
QUALITY SUPPORTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HORTENSIA HOWARD (PRESIDENT)
(314) 921-3163
Entity
Organization
Contact information
Practice address
840 SPRINTERS ROW DR, FLORISSANT, MO 63034-3366
(314) 921-3163
Mailing address
840 SPRINTERS ROW DR, FLORISSANT, MO 63034-3366
(314) 921-3163
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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