INDEPENDENCE CENTER (NPI# 1780720680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780720680 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE CENTER |
| Other Organization Name | NEWSTEAD PLACE |
| Practice Address |
19 N Newstead Ave Saint Louis MO 63108-2260 |
| Mailing Address |
8675 Olive Blvd Saint Louis MO 63132-2503 |
| Practice Telephone | 3142864510 |
| Practice Fax Number | 3142864565 |
| Mailing Telephone | 3143735187 |
| Mailing Fax Number | 3143675626 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MIKE KELLER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3145334380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 033539 | MO | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Newstead Place | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760839260 | Independence Center | Clinic/Center | 4245 Forest Park Ave, Saint Louis, MO 63108-2810 | 2016-05-16 |
| 1619146420 | Independence Center | Community/Behavioral Health | 320 N Ash St, Waukegan, IL 60085-3985 | 2008-02-26 |
| 1699944413 | Independence Center | Case Management | 813 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1881863603 | Independence Center | Case Management | 815 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1235308057 | Independence Center | Case Management | 817 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1427227230 | Independence Center | Case Management | 819 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1336318153 | Independence Center | Case Management | 1730 Washington St, Waukegan, IL 60085-5102 | 2008-02-26 |
| 1427227248 | Independence Center | Case Management | 2835 Washington St, Waukegan, IL 60085-4839 | 2008-02-26 |
| 1972772788 | Independence Center | Case Management | 2839 Washington St, Waukegan, IL 60085-4839 | 2008-02-26 |
| 1558494286 | Independence Center | Community/Behavioral Health | 8675 Olive Blvd, Saint Louis, MO 63132-2503 | 2007-03-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDEPENDENCE CENTER INC | 2025 Washington St, Waukegan, IL 60085-5131 |
| Massachusetts Corporations | INDEPENDENCE CENTER LLC | 4 Clinton Square, C/o The Clinton Companies, Syracuse, NY 13202 |
| Massachusetts Corporations | INDEPENDENCE CENTER NEWCO LLC | The Clinton Exchange, 4 Clinton Square, C/o The Pyramid Companies, Syracuse, NY 13202 |
| Street Address |
19 N NEWSTEAD AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-2260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790038321 | Pleasant Solutions Home Health Care,llc | Community Based Residential Treatment Facility, Mental Illness | 100 Rue St. Francios Suite 107, Saint Louis, MO 63031 | 2012-10-19 |
| 1922358423 | Smiley Manor | Community Based Residential Treatment Facility, Mental Illness | 5415 Thekla, Saint Louis, MO 63120 | 2012-09-12 |
| 1184811101 | Frasat LLC | Community Based Residential Treatment Facility, Mental Illness | 3715 Saint Anns Ln, Saint Louis, MO 63121-4813 | 2007-10-03 |
| 1922298777 | Oasis Residential Care Inc | Community Based Residential Treatment Facility, Mental Illness | 5626 Maffitt Ave, Saint Louis, MO 63112-4010 | 2007-07-27 |
| 1881806743 | Oasis Residential Care Inc | Community Based Residential Treatment Facility, Mental Illness | 3508 Prairie Ave, Saint Louis, MO 63107-2214 | 2007-05-04 |
| 1396863031 | Mccb Transitions, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4110 Saint Louis Ave, Saint Louis, MO 63115-3218 | 2007-03-27 |
| 1174669006 | Independence Center | Community Based Residential Treatment Facility, Mental Illness | 2443 Prouhet Ave, Saint Louis, MO 63114-1946 | 2007-01-29 |
| 1366646481 | Mccb Transitions, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4110 Saint Louis Ave, Saint Louis, MO 63115-3218 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720642010 | Southview Health Care, LLC. | Community Based Residential Treatment Facility, Mental Illness | 951 Creamery Rd, West Plains, MO 65775-6052 | 2019-04-23 |
| 1902369663 | Anna Dodson Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4616 Hwy D, Farmington, MO 63640-7241 | 2019-04-10 |
| 1760940209 | Lea-ed Inc | Community Based Residential Treatment Facility, Mental Illness | 30 Sherman Road, Lemay, MO 63125 | 2019-03-04 |
| 1467919233 | Ted-lea, Inc. | Community Based Residential Treatment Facility, Mental Illness | 9444 Midland Blvd, Overland, MO 63114-3328 | 2019-02-27 |
| 1639633290 | Synergy Executive, LLC | Community Based Residential Treatment Facility, Mental Illness | 2608 Smyrna Rd, Ozark, MO 65721-7674 | 2019-01-29 |
| 1467958553 | Swope Health Services | Community Based Residential Treatment Facility, Mental Illness | 2614 Benton Blvd, Kansas City, MO 64127-4149 | 2018-04-05 |
| 1053827964 | Dianas Boarding Home Inc | Community Based Residential Treatment Facility, Mental Illness | Hc 64, Box 4683, Marble Hill, MO 63764 | 2017-12-15 |
| 1689098188 | Venus Independent Living LLC | Community Based Residential Treatment Facility, Mental Illness | 301 S Coffey St, Vienna, MO 65582-8862 | 2014-02-05 |
| 1699108381 | Sunny Hill, Inc. | Community Based Residential Treatment Facility, Mental Illness | 134 Gray St, Festus, MO 63028-1949 | 2013-08-16 |
| 1902167067 | Support Professionals II | Community Based Residential Treatment Facility, Mental Illness | 8540 Blue Ridge, Kansas City, MO 64138 | 2012-06-06 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
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| 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.