STATE OF MISSOURI (NPI# 1760681415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760681415 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSOURI |
| Other Organization Name | HIGHLANDS GROUP HOME |
| Practice Address |
1501 N River Blvd Independence MO 64050-1760 |
| Mailing Address |
1706 E Elm St Jefferson City MO 65101-4130 |
| Practice Telephone | 8165127515 |
| Practice Fax Number | 8165127517 |
| Mailing Telephone | 5737513398 |
| Mailing Fax Number | 5735264560 |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-10-20 |
| Authorized Official Name | MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Telephone | 5737514055 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSOURI |
| 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 |
| Other Name | Type Code |
|---|---|
| Highlands Group Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781499 | State of Missouri | Rehabilitation Counselor | 3418 Knipp Dr, Jefferson City, MO 65109-5701 | 2020-02-07 |
| 1275073280 | State of Missouri | General Practice | 1547 W Commerce Drive, Marshall, MO 65340-3907 | 2017-02-24 |
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1386843621 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15555 Little Blue Rd, Kansas City, MO 64139 | 2007-07-17 |
| 1922207679 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5410 Rinker Rd, Kansas City, MO 64129-2308 | 2007-07-13 |
| 1164630463 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 11 Brady Cir, Overland, MO 63114-1110 | 2007-05-18 |
| 1548322605 | State of Missouri | Day Training, Developmentally Disabled Services | 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 | 2006-12-15 |
| 1366503153 | State of Missouri | Day Training, Developmentally Disabled Services | 471 E Slater St, Marshall, MO 65340 | 2006-12-13 |
| 1427118033 | State of Missouri | Day Training, Developmentally Disabled Services | 522 Star St, Marshall, MO 65340 | 2006-12-12 |
| 1902966500 | State of Missouri | Day Training, Developmentally Disabled Services | 504 N Elm St, Marshall, MO 65340 | 2006-12-12 |
| Street Address |
1501 N RIVER BLVD |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64050-1760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841698024 | Joshonna Price | Occupational Therapy Assistant | 810 E Walnut, Independence, MO 64050 | 2014-12-19 |
| 1003151770 | Melinda Stegner | Registered Nurse | 3445 South 291 Hwy, Ste 300, Independence, MO 64050 | 2012-12-06 |
| 1194075788 | Healthstat- Independence School District | Preventive Medicine | 1516 W. Maple, Independence, MO 64050 | 2012-09-12 |
| 1568790749 | Charity Faith Morris | Case Manager/Care Coordinator | 314 E Pacific Avenue, Independence, MO 64050 | 2009-11-25 |
| 1225276090 | Best Smile, LLC | Dentist | 651 E 24 Hwy, Independence, MO 64050 | 2009-02-01 |
| 1396982468 | Independence Avenue Dental LLC | Clinic/Center | 1638 West 24 Highway, Independence, MO 64050 | 2009-01-12 |
| 1366640914 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1215 W. Truman Rd, Independence, MO 64050 | 2007-07-05 |
| 1992871883 | Stephen Ervin Dorsch | Family Medicine | 1638 W 24 Hwy, Independence, MO 64050 | 2006-11-24 |
| 1831284801 | Ronald Eugene Jennings | Dentist | 514 S Noland Road, Noland Medical Plaza Suite 120, Independence, MO 64050 | 2006-10-04 |
| 1841393782 | Carmel Hills Healthcare and Rehabilitation Center, LLC | Skilled Nursing Facility | 810 East Walnut, Independence, MO 64050 | 2006-09-06 |
| Find all providers in zip 64050 | ||||
| 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 |
|---|---|---|---|---|
| 1750738084 | Building On Dreams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 638 Rockwell Ave, Independence, MO 64056-3132 | 2016-05-17 |
| 1518245745 | Harry S Truman Childrens Neurological Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12404 E Us Highway 40, Independence, MO 64055-5954 | 2011-07-21 |
| 1598083867 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 27683 Ivy Springs Dr, Independence, LA 70443-4927 | 2010-05-12 |
| 1386967495 | Care By Cassie Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 500 E Bellevista Dr, Independence, MO 64055-1748 | 2010-03-03 |
| 1932432291 | Care By Cassie, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3514 S Cottage Ave, Independence, MO 64055-3133 | 2009-09-17 |
| 1033383641 | Community Access | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1402 S Lees Summit Rd, Independence, MO 64050-4117 | 2008-04-15 |
| 1164601357 | Care By Cassie | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3816 S Union St, Independence, MO 64055-3150 | 2007-10-24 |
| 1366640914 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1215 W. Truman Rd, Independence, MO 64050 | 2007-07-05 |
| 1558569103 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3704 S. Blue Ridge Blvd, Independence, MO 64052 | 2007-07-05 |
| 1477672426 | Northstar Residential Care, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18805 Hanthorne Dr, Independence, MO 64057-1676 | 2007-03-29 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 64050 |
Please comment or provide details below to improve the information on STATE OF MISSOURI.
| 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.