Whalio Doctors

NPI 1326514381

Clark Supported Living

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Columbia, MO

Practice location

Address
303 Macaw Dr, Columbia, MO 65202
Phone
(773) 332-6106
Mailing address
303 Macaw Dr, Columbia, MO 65202-6284

Authorised official

Name
Zondra D Clark
Title
Executive Director
Phone
(773) 332-6106

Registered specialties (15)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X
Community Health Registered Nurse
Nursing Service Providers Taxonomy 163WC1500X
Meals Provider
Other Service Providers Taxonomy 174200000X
Case Management Agency
Agencies Taxonomy 251B00000X
Nursing Care Agency
Agencies Taxonomy 251J00000X
Community/Behavioral Health Agency
Agencies Taxonomy 251S00000X
Supports Brokerage Agency
Agencies Taxonomy 251X00000X
In Home Supportive Care Agency
Agencies Taxonomy 253Z00000X
Adult Day Care Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QA0600X
Developmental Disabilities Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QD1600X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320900000X
Respite Care
Respite Care Facility Taxonomy 385H00000X
Child Mental Illness Respite Care
Respite Care Facility Taxonomy 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care
Respite Care Facility Taxonomy 385HR2060X
Child Physical Disabilities Respite Care
Respite Care Facility Taxonomy 385HR2065X

Registry record

NPI
1326514381
Entity type
Organization
NPI issued
17 Oct 2018
Record last updated
17 Oct 2018

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.