Organization
TRI-COUNTY CENTER FOR INDEPENDENT LIVING
Active
Other names
Home Outreach for Personal Excellence
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS WILLIAMS (EXECUTIVE DIRECTOR)
(573) 368-5933
Entity
Organization
Contact information
Practice address
1420 E STATE ROUTE 72, ROLLA, MO 65401-3988
(573) 368-5933
(573) 368-5991
Mailing address
1420 E STATE ROUTE 72, ROLLA, MO 65401-3988
(573) 368-5933
(573) 368-5991
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276236205
—
MO
Enumeration date
08/09/2012
Last updated
01/20/2014
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