Organization
COLEMAN SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH COLEMAN LPN (CEO)
(573) 673-9715
Entity
Organization
Contact information
Practice address
1554 DOVER CT, LIBERTY, MO 64068-3288
(573) 673-9715
Mailing address
1554 DOVER CT, LIBERTY, MO 64068-3288
(573) 673-9715
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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