OrganizationActive
Community Residence, Inc.
NPI 1376540872 · Adult Care Home Facility · Seneca, MO
Provider details
- NPI number
- 1376540872
- Entity type
- Organization
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Authorized official
- James Giardina, President
- License
- 029629 (MO)
Practice location
2400 Cherokee Ave
Seneca, MO 64865-9323
Phone: (417) 776-8053
Fax: (417) 776-1683
Mailing address
312 Solley Dr
Ballwin, MO 63021-5248
Registry dates
- Enumerated
- 2005-06-30
- Last updated
- 2007-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.