Organization
COMMUNITY RESIDENCE, INC.
Active
Other names
Mt Vernon Residential Care
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GIARDINA (PRESIDENT)
(636) 394-3000
Entity
Organization
Contact information
Practice address
1425B S LANDRUM ST, MOUNT VERNON, MO 65712-1912
(417) 466-3649
(417) 466-4909
Mailing address
312 SOLLEY DR, REAR, BALLWIN, MO 63021-5248
(636) 394-3000
(636) 394-7713
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
029793
MO
Other
Enumeration date
06/30/2005
Last updated
10/30/2007
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