Healthcare Provider Details

I. General information

NPI: 1407901747
Provider Name (Legal Business Name): ARBORS OF COLUMBIA RESIDENTIAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 BLUFF CREEK DR
COLUMBIA MO
65201-3524
US

IV. Provider business mailing address

3100 BLUFF CREEK DR
COLUMBIA MO
65201-3524
US

V. Phone/Fax

Practice location:
  • Phone: 573-256-5565
  • Fax: 573-256-5112
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: JAMES REIKER
Title or Position: TREASURER
Credential:
Phone: 573-471-1113