OrganizationActive
Community Residence, Inc.
NPI 1679570170 · Adult Care Home Facility · Boss, MO
Provider details
- NPI number
- 1679570170
- Entity type
- Organization
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- James Giardina, President(636) 394-3000
- License
- 030558 (MO)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
32 Highway
Boss, MO 65440
Phone: (573) 626-4611
Fax: (573) 626-4611
Approximate (ZIP-level) locationGet directions
Mailing address
312 Solley Dr
Ballwin, MO 63021-5248
Other names (DBA / former)
- Doing business as
- Boss Residential Care
Registry dates
- Enumerated
- 2005-06-30
- 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.