Organization
TDIII,INC
Active
Other names
Crane Residential Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY HALL DAVIDSON III (CEO)
(417) 890-8172
Entity
Organization
Contact information
Practice address
102 E LILLIAN AVE, CRANE, MO 65633-9103
(417) 723-5900
(417) 723-8559
Mailing address
4781 S TWIN LAKES AVE, SPRINGFIELD, MO 65810-1548
(417) 723-5900
(417) 723-8559
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
033564
MO
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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