Organization
SOUTHERN MISSOURI SUPPORTED LIVING
Active
Other names
SMSL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT HOLLIS (OWNER)
(573) 447-0905
Entity
Organization
Contact information
Practice address
RR 2 BOX 2610, ALTON, MO 65606-9633
(417) 778-1685
Mailing address
4909 COCHERO CT, COLUMBIA, MO 65203-9758
(573) 447-0905
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
MO
385H00000X
Respite Care
—
MO
Other
Enumeration date
03/25/2007
Last updated
09/11/2025
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