FIDELIS SUPPORT SERVICES LLC


Address: 3905 Faurot Dr, Columbia, MO 65203-0309
Phone: 5734244367

FIDELIS SUPPORT SERVICES LLC (NPI# 1699082743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699082743
Entity Type Organization
Organization Name FIDELIS SUPPORT SERVICES LLC
Practice Address 3905 Faurot Dr
Columbia
MO 65203-0309
Practice Telephone 5734244367
Mailing Telephone 5734244367
Enumeration Date 2010-09-10
Last Update Date 2010-09-10
Authorized Official Name MR. DOUGLAS L EDGAR (OWNER/QDDP)
Authorized Official Telephone 5734244367
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Office Location

Street Address 3905 FAUROT DR
City COLUMBIA
State MO
Zip Code 65203-0309

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982229498 Rebecca Wallace Counseling LLC Clinic/Center 207 Peach Way, Suite 110, Columbia, MO 65203 2020-06-10
1144797101 Mary Zhang Family Medicine 200 Southampton Drive, Ste 102, Columbia, MO 65203 2018-10-29
1871090258 Hina Omer Khokhar Pathology 4601 Apt F West Millbrook Dr, Columbia, MO 65203 2018-04-11
1154820157 David Vincent Spencer Internal Medicine 201 W Broadway Building, Suite E, Columbia, MO 65203 2018-02-05
1598283103 Donna Strickland Counselor 201 W Broadway Bldg 2, Suite F, Columbia, MO 65203 2017-09-03
1134643182 Anna Kathryn Christensen Physician Assistant 4107 Baurichter Dr., Columbia, MO 65203 2017-08-01
1558885871 Juan Camilo Pineda Internal Medicine 210 Portland Street Suite 104, Columbia, MO 65203 2017-07-28
1922530096 The Missing L Inc Community/Behavioral Health 3605 S. Providence Rd, Suite 6, Columbia, MO 65203 2017-03-29
1689118010 Linda Landry Nurse Practitioner 1000 W. Nifong, Bldg 2 Suite 150, Columbia, MO 65203 2016-12-04
1417313552 Brittany Lea Ramirez Chiropractor 2001 Corona Rd Ste 205, Columbia, MO 65203 2016-01-05
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285257816 The Behavior Co. LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 10 Cardington Ct, Columbia, SC 29209-3241 2020-05-18
1891213690 The Arc, Warren County Chapter Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 46 Koeck Rd, Columbia, NJ 07832-2007 2017-09-01
1124561907 Eric Vahle Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3611 Wakefield Dr, Columbia, MO 65203-4462 2016-11-28
1104201540 Willowglen Academy-new Jersey, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 288 Route 94, Columbia, NJ 07832 2015-07-28
1952781866 Rem New Jersey, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 302 Route 94, Columbia, NJ 07832-2771 2015-06-05
1699076711 Independent Living Concepts, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2704 Andy Dr, Columbia, MO 65202-2012 2010-11-05
1801121397 Integrated Lifestyles LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 820 Bourn Ave, Columbia, MO 65203-1459 2009-10-16
1922243955 Robert Verdell Palmer Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2401 Edmonds Ct, Columbia, MO 65203-8465 2008-12-04
1992970107 Florence Denise Rainey Hicks Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1501 Lambeth Dr, Columbia, MO 65202-2462 2008-04-29
1952574063 Colwell Interest, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4813 Highway 4 E, Columbia, LA 71418-3512 2008-04-09
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Competitor

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City COLUMBIA
Zip Code 65203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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