NPI 1164792917
Jefferson City Residential, LLC
Practice location
- Address
- 3409 N Ten Mile Dr, Jefferson City, MO 65109-0530
- Phone
- (573) 471-1113
Authorised official
- Name
- Kyle Timothy Schade
- Title
- Manager
- Phone
- (573) 471-1113
Registered specialties
Alzheimer Center (Dementia Center)
Primary
Registry record
- NPI
- 1164792917
- Entity type
- Organization
- NPI issued
- 11 Jan 2012
- Record last updated
- 2 Feb 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.