Organization
STANBERRY INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM MILLER (MANAGER)
(660) 783-2093
Entity
Organization
Contact information
Practice address
1319 NORTH ALANTHUS ST., STANBERRY, MO 64489-0160
(660) 783-2093
(660) 783-2013
Mailing address
1319 NORTH ALANTHUS ST., STANBERRY, MO 64489-0160
(660) 783-2093
(660) 783-2013
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
347C00000X
Private Vehicle
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/22/2007
Last updated
09/11/2025
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