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General NPI Number Information
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NPI Number | 1629284823
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Entity Type | Organization
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Legal Business Name | HOUSER COMMUNITY SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1308 ROBERT RAY DR
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City | COLUMBIA
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State | MO
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Zip | 65202-3508
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Country | US
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Telephone | 573-442-1740
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Fax | 573-442-1740
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Provider Business Mailing Address
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Address Line | 2905 LYNNWOOD DR
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City | COLUMBIA
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State | MO
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Zip | 65203-2942
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Country | US
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Telephone | 573-442-1740
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Fax | 573-442-1740
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Authorized Official
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Title or Position | OWNER
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Name | MR. NORMAN HAROLD HOUSER
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Credential | PSYCHOLOGIST
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Telephone | 573-442-1740
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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 |
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License Number State |
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