OrganizationActive
Alice Sue Conrad
NPI 1922128487 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Columbia, MO
Provider details
- NPI number
- 1922128487
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Alice Conrad, Owner(573) 875-6751
- License
- 8001661 (MO)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 8001661 (MO)
Residential Treatment Facilities
Practice location
1407 Saint Andrew St
Columbia, MO 65203-2327
Phone: (573) 875-6751
Fax: (573) 442-2086
Approximate (ZIP-level) locationGet directions
Mailing address
1407 Saint Andrew St
Columbia, MO 65203-2327
Registry dates
- Enumerated
- 2007-03-29
- Last updated
- 2008-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.