MRS. MICHELE RENEE MULLENDORE (NPI# 1871892604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871892604 |
| Entity Type | Individual |
| Full Name | MRS. MICHELE RENEE MULLENDORE |
| Credential | BCBA |
| Practice Address |
702 Maple Leaf St Dearborn MO 64439-9116 |
| Practice Telephone | 8163046141 |
| Mailing Telephone | 8163046141 |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2012-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2011004826 | MO | Residential Treatment Facilities |
| N | 103K00000X | Behavioral Analyst | 2011004826 | MO | Behavioral Health & Social Service Providers |
| Street Address |
702 MAPLE LEAF ST |
| City | DEARBORN |
| State | MO |
| Zip Code | 64439-9116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558558429 | Daniels Family Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24215 Highway Y, Dearborn, MO 64439-9114 | 2007-09-25 |
| 1053562595 | David C. Daniels | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24215 Highway Y, Dearborn, MO 64439-9114 | 2008-10-02 |
| 1427235548 | North Platte County R-i | Local Education Agency (LEA) | 212 W 6th St, Dearborn, MO 64439-9400 | 2008-01-31 |
| 1417259029 | Lynne Katrene Pippin | Anesthesiology | 23725 Camp Pawnee Rd, Dearborn, MO 64439-9424 | 2010-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679485 | Thrive Physical Therapy | Clinic/Center | 835 Mason St Ste A245, Dearborn, MI 48124-2231 | 2020-11-06 |
| 1609477710 | Alix Sabbagh | Pharmacist | 154 River Ln, Dearborn, MI 48124-1047 | 2020-11-04 |
| 1437759396 | Zainab Ali Hachem | Nurse Practitioner | 5158 Neckel St, Dearborn, MI 48126-3217 | 2020-10-29 |
| 1487254850 | Rola Ajami | Nurse Practitioner | 4964 Rosalie St, Dearborn, MI 48126-2831 | 2020-10-27 |
| 1760081467 | Sam Nasser | Pharmacist | 6610 Reuter St, Dearborn, MI 48126-1898 | 2020-10-22 |
| 1740889146 | Samaah Abboud Khanafer | Occupational Therapist | 1036 N Denwood St, Dearborn, MI 48128-1569 | 2020-10-19 |
| 1851990287 | Salem Ali Ahmad | Physical Therapy Assistant | 835 Mason St Ste 245, Dearborn, MI 48124-2231 | 2020-10-17 |
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1730787912 | Batoul Kassem | Specialist/Technologist | 6045 Steadman St, Dearborn, MI 48126-2052 | 2020-10-11 |
| 1063019099 | Yassin Mohamed | Pharmacist | 4216 Bingham St, Dearborn, MI 48126-3611 | 2020-10-02 |
| Find all providers in DEARBORN | ||||
| 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 |
|---|---|---|---|---|
| 1558558429 | Daniels Family Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24215 Highway Y, Dearborn, MO 64439-9114 | 2007-09-25 |
| 1053562595 | David C. Daniels | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24215 Highway Y, Dearborn, MO 64439-9114 | 2008-10-02 |
| 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 | ||||
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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.