Organization
ROLLA RESIDENTIAL, LLC
Active
Other names
Parkside Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE TIMOTHY SCHADE (MANAGER)
(573) 471-1113
Entity
Organization
Contact information
Practice address
2100 PARKSIDE AVE, ROLLA, MO 65401-5472
(573) 308-0384
(573) 308-1644
Mailing address
2100 PARKSIDE AVE, ROLLA, MO 65401-5472
(573) 308-0384
(573) 308-1644
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
MO
Enumeration date
05/26/2006
Last updated
02/02/2026
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