OrganizationActive
Boone Supported Living, LLC
NPI 1568680403 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hannibal, MO
Provider details
- NPI number
- 1568680403
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Julie Walden, Member
Mailing address
5 Marsh Cir
Hannibal, MO 63401-2479
Registry dates
- Enumerated
- 2007-04-24
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.