National Provider Identifier Database

TRI COUNTY CENTER FOR INDEPENDENT LIVING
Voluntary or Charitable


Contact Information

TRI-COUNTY CENTER FOR INDEPENDENT LIVING
1420 E STATE ROUTE 72
ROLLA, MO65401-3988
Phone: 573-368-5933
Fax: 573-368-5991
Website:
Specialty Taxonomy Code
* Voluntary or Charitable 251V00000X

* Indicates primary specialty

NPI Profile & details for TRI-COUNTY CENTER FOR INDEPENDENT LIVING

NPI Number 1720115579
Legal business name
LBN
TRI-COUNTY CENTER FOR INDEPENDENT LIVING
Authorized official DOUGLAS WILLIAMS - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 02/28/2007
Last updated 07/26/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Medicaid: 266236207

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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