WILLOW CREEK GROUP HOME


Address: Rte. 2, Box 27, 501 Baker Street, Adrian, MO 64720
Phone: 8162974256

WILLOW CREEK GROUP HOME (NPI# 1871897017) 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) 1871897017
Entity Type Organization
Organization Name WILLOW CREEK GROUP HOME
Other Organization Name WILLOW CREEK GROUP HOME SOUTH
Practice Address Rte. 2, Box 27
501 Baker Street
Adrian
MO 64720
Practice Telephone 8162974256
Practice Fax Number 8162978956
Mailing Telephone 8162974256
Mailing Fax Number 8162978956
Enumeration Date 2011-01-03
Last Update Date 2011-01-03
Authorized Official Name MRS. JEANIE SUE STEPHENS (OWNER)
Authorized Official Telephone 8162974256
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 134112203 MO Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Willow Creek Group Home South Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1942544820 Willow Creek Group Home Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Rural Route 2, Box 27, Adrian, MO 64720 2012-11-16

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names WILLOW CREEK GROUP HOME LLC 1113 Icel Ct Ne, Salem, OR 97301

Office Location

Street Address RTE. 2, BOX 27
501 BAKER STREET
City ADRIAN
State MO
Zip Code 64720

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942544820 Willow Creek Group Home Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Rural Route 2, Box 27, Adrian, MO 64720 2012-11-16
1477659779 Adrian Kreisler Drug Inc. Durable Medical Equipment & Medical Supplies 21 E Main St., Adrian, MO 64720 2006-09-15
1538187711 Adrian Clinic, LLC Nurse Practitioner 57 East Main Street, Adrian, MO 64720 2006-07-17
1316941826 Laura J Thiem Nurse Practitioner 57 East Main, Adrian, MO 64720 2005-06-13
1578797494 Bates County Memorial Hospital Family Medicine 102 E. Main, Adrian, MO 64720 2009-05-06
1407046618 Bates County Memorial Hospital Clinic/Center 102 E. Main, Adrian, MO 64720 2007-07-25
1568532265 James Chandler Womelduff Iv Chiropractor 33 E Main St, Adrian, MO 64720 2006-11-09
1720635444 Deborah Lovnne Beard Technician 14540 Nw County Road 1001, Adrian, MO 64720-4833 2019-08-19
1992285878 Hannah Elizabeth Clayton Behavior Technician 15415 Nw State Route Aa, Adrian, MO 64720-4890 2018-08-20
1609387240 Tammy Michelle Stone Assisted Living Facility 431 Ne County Road 10564, Adrian, MO 64720-5111 2017-10-23
Find all providers in zip 64720

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
1942544820 Willow Creek Group Home Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Rural Route 2, Box 27, Adrian, MO 64720 2012-11-16
1124162227 Christine Lynn Bohannon Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Box 64 303 W Main St, Adrian, MO 64720-9217 2007-02-20
1922141068 Willow Creek Group Home, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Rr 2 Box 27, Adrian, MO 64720-9587 2007-02-15
1255804472 Four Seasons of Adrian, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 303 W Main St, Adrian, MO 64720-9217 2019-01-10

Providers in the same taxonomy and state

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

Competitor

Search similar providers

City ADRIAN
Zip Code 64720

Improve Information

Please comment or provide details below to improve the information on WILLOW CREEK GROUP HOME.

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.

Trending Searches