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General NPI Number Information
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NPI Number | 1518091354
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Entity Type | Organization
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Legal Business Name | CITADEL ASSOCIATION, INC.
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 217 E CITADEL DR
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City | POTOSI
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State | MO
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Zip | 63664-1937
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Country | US
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Telephone | 573-438-3736
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Fax | 573-436-9200
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Provider Business Mailing Address
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Address Line | 217 E CITADEL DR
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City | POTOSI
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State | MO
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Zip | 63664-1937
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Country | US
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Telephone | 573-438-3736
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Fax | 573-436-9200
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Authorized Official
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Title or Position | CEO
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Name | MISS GEORGIA I. EYE
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Credential |
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Telephone | 573-438-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 1799-330
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 1799-330
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License Number State | MO
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