Organization
INDEPENDENT LIVING CONCEPTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HAHN (ADMINISTRATOR)
(573) 356-8915
Entity
Organization
Contact information
Practice address
2704 ANDY DR, COLUMBIA, MO 65202-2012
(573) 356-8915
Mailing address
2704 ANDY DR, COLUMBIA, MO 65202-2012
(573) 356-8915
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/05/2010
Last updated
11/29/2010
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