NPI 1962644401
Colonial House of Crystal City, LLC
Practice location
- Address
- 26 Mississippi Ave, Crystal City, MO 63019-1817
- Phone
- (636) 937-1000
- Fax
- (636) 937-1003
- Mailing address
- 115 West Ave, Festus, MO 63028-1733
Authorised official
- Name
- Alysha Lynn Sauer
- Title
- Member
- Phone
- (636) 933-4911
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1962644401
- Entity type
- Organization
- NPI issued
- 30 Mar 2009
- Record last updated
- 30 Mar 2009
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.