Organization
CASS COUNTY COMMUNITY LIVING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLA YAVONNE TALCOTT (DIRECTOR)
(816) 380-6322
Entity
Organization
Contact information
Practice address
1909 S JEFFERSON PKWY, HARRISONVILLE, MO 64701-3712
(816) 380-6322
(816) 380-3308
Mailing address
1909 S JEFFERSON PKWY, HARRISONVILLE, MO 64701-3712
(816) 380-6322
(816) 380-3308
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6825656
VENDOR HILLCREST PLACE 2
MO
01
—
6825664
KNOLLBROOK 2
MO
01
—
7156251
ISL 2
MO
Enumeration date
02/21/2007
Last updated
08/22/2020
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