LACI'S HAVEN (NPI# 1730527904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730527904 |
Entity Type | Organization |
Organization Name | LACI'S HAVEN |
Practice Address |
713 Salem Ave Suite E Rolla MO 65401-3444 |
Practice Telephone | 5734653654 |
Practice Fax Number | 8888588055 |
Mailing Telephone | 5732018654 |
Mailing Fax Number | 8888588055 |
Enumeration Date | 2013-06-10 |
Last Update Date | 2017-10-11 |
Authorized Official Name | MARIA LEWIS (DIRECTOR, ADMINISTRATOR, PRESIDENT) |
Authorized Official Telephone | 5732018654 |
Authorized Official Credential | RN |
Is Organization Subpart | N |
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 |
Street Address |
713 SALEM AVE SUITE E |
City | ROLLA |
State | MO |
Zip Code | 65401-3444 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770542870 | Linda Kay Westmoreland | Dentist | 713 Salem Ave, Suite A., Rolla, MO 65401-3444 | 2006-03-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
Find all providers in zip 65401 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437668340 | Phelps County Industrial Solutions Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3900 Hy Point Blvd, Rolla, MO 65401-7841 | 2017-09-22 |
1497133243 | Preferred Family Healthcare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1212 E State Route 72, Suite 8, Rolla, MO 65401-3938 | 2015-05-13 |
1164603072 | Mi Serenity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11840 Private Drive 5136, Rolla, MO 65401-5909 | 2007-11-19 |
1386848794 | Future Care, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1401 Forum Dr # A, Rolla, MO 65401-2508 | 2007-06-12 |
1144349259 | Jeannie Gloria Dake | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1101 Strobach St, Rolla, MO 65401-4243 | 2007-03-28 |
1770607780 | Future Care, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1401 Forum Dr, Rolla, MO 65401-2508 | 2007-03-16 |
1376763292 | Reliable Home Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1106 Laguille Ct, Rolla, MO 65401-3440 | 2007-04-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609475516 | Brandi Janelle Hickman | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8706 Newton Ave Apt 4101, Kansas City, MO 64138-5461 | 2020-10-21 |
1154935112 | Overcomers Counseling Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17101 East 203rd St, Peculiar, MO 64078 | 2020-09-06 |
1386265965 | Candace Palmer | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2405 Bowe Ln, Jefferson City, MO 65109-9116 | 2020-05-05 |
1902426596 | Matt Ferguson | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4480 Bradley Dr, Joplin, MO 64804-5503 | 2020-04-23 |
1689206211 | Insight Industry LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2501 Ne Prairie Falcon Dr, Blue Springs, MO 64014-1958 | 2020-02-11 |
1598306904 | Hearo Technologies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 N Jefferson Ave Ste 1063, Springfield, MO 65806-1110 | 2019-10-07 |
1437790219 | Darin Roark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2628 Se Kimbrough Ln, Lees Summit, MO 64063-1082 | 2019-10-03 |
1942851399 | Wyatt's Dream Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 205 State Highway Aa, Sikeston, MO 63801-5303 | 2019-09-26 |
1043871908 | Cura Personalis, (care for The Whole Person), LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11650 Bobwhite Road, Carthage, MO 64836 | 2019-06-21 |
1043870181 | Rebuild Contracting LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1783 Possum Hollow Dr, Camdenton, MO 65020-6709 | 2019-06-20 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on LACI'S HAVEN.
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.