GREEN MAXVILLE SUPPORTIVE LIVING LLC
NPI 1235511692
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Columbia, MO

Q: What is Green Maxville Supportive Living LLC's NPI number?

The NPI number for Green Maxville Supportive Living LLC is 1235511692. It was assigned to this organization in the NPPES registry on June 22, 2015.

Q: What is Green Maxville Supportive Living LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Active since June 22, 2015

101 E ALHAMBRA DR, COLUMBIA, MO 65203(573) 864-9743(573) 874-1723 Get Directions Write a Review

NPPES record last updated: June 22, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Green Maxville Supportive Living Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREEN MAXVILLE SUPPORTIVE LIVING LLC (NPI 1235511692) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Columbia, Missouri and active in the NPI registry since June 2015. The organization lists Dale A Maxville, President/owner, as its authorized official.

NPPES Registry Identity

NPI1235511692

Entity TypeOrganization

Primary Taxonomy320900000X

Legal Business NameGREEN MAXVILLE SUPPORTIVE LIVING LLC

Location Address101 E ALHAMBRA DRColumbia, MO 65203-3763

Mailing Address5900 Galli LnCollinsville, IL 62234-5836 · (573) 864-9743 · Fax (573) 874-1713

Phone(573) 864-9743

Fax(573) 874-1723

Organization SubpartNo

Authorized OfficialDale A MaxvillePresident/owner · (573) 864-9743

Enumeration DateJune 22, 2015

✔ NPI 1235511692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

101 E ALHAMBRA DR, Columbia, MO 65203

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Green Maxville Supportive Living LLC's NPI number?

The NPI number for Green Maxville Supportive Living LLC is 1235511692. It was assigned to this organization in the NPPES registry on June 22, 2015.

Where is Green Maxville Supportive Living LLC located?

Green Maxville Supportive Living LLC is located at 101 E Alhambra Dr, Columbia, MO 65203. The listed phone number is (573) 864-9743.

What is Green Maxville Supportive Living LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Green Maxville Supportive Living LLC was last updated on June 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.