LONE PINE RESIDENTIAL CARE, LLC (NPI# 1942327143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942327143 |
| Entity Type | Organization |
| Organization Name | LONE PINE RESIDENTIAL CARE, LLC |
| Practice Address |
321 S Main St Ironton MO 63650-1406 |
| Mailing Address |
231 S Main St Suite B Ironton MO 63650-1307 |
| Practice Telephone | 5735467283 |
| Practice Fax Number | 5735466102 |
| Mailing Telephone | 5735461616 |
| Mailing Fax Number | 5735466465 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PATRICIA ANDERSON (SECRETARY) |
| Authorized Official Telephone | 5735461616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
031985 | MO | Nursing & Custodial Care Facilities |
| Street Address |
321 S MAIN ST |
| City | IRONTON |
| State | MO |
| Zip Code | 63650-1406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578128971 | Granite House Rcf LLC | Assisted Living Facility | 321 S Main St, Ironton, MO 63650-1406 | 2019-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972756633 | East Missouri Action Agency, Inc | Clinic/Center | 606 West Russell, Ironton, MO 63650 | 2008-10-28 |
| 1326008533 | Vatana C. Boonyasai | Family Medicine | 200 St.mary's Street, Lower Level, Pilot Knob, MO 63650 | 2006-03-23 |
| 1194074302 | Robert Franklin Dettmer Sr. | General Practice | 3 Longwood Lane, Ironton, MO 63650-0307 | 2012-09-04 |
| 1578542924 | Arcadia Valley Drug Acquisition Co | Durable Medical Equipment & Medical Supplies | 605 N Main St, Ironton, MO 63650-1006 | 2006-01-13 |
| 1053978643 | Michelle Bobbett | Pharmacist | 605 N Main St, Ironton, MO 63650-1006 | 2019-05-20 |
| 1184016578 | Rebecca Barron | Pharmacist | 605 N Main St, Ironton, MO 63650-1006 | 2015-02-23 |
| 1902152929 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 605 N Main St, Ironton, MO 63650-1006 | 2012-07-27 |
| 1831457027 | Frederick G Dietzler | Pharmacist | 605 N Main St, Ironton, MO 63650-1006 | 2012-04-25 |
| 1831417682 | Southeast Missouri Behavioral Health | Clinic/Center | 143 S Main St, Ironton, MO 63650-1305 | 2010-05-04 |
| 1942451083 | Erika Michelle Parks | Pharmacist | 124 W Russell St, Ironton, MO 63650-1313 | 2008-10-07 |
| Find all providers in zip 63650 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861519118 | Ironton Care Center LLC | Assisted Living Facility | 101 S Knob St, Ironton, MO 63650-1501 | 2007-03-23 |
| 1578128971 | Granite House Rcf LLC | Assisted Living Facility | 321 S Main St, Ironton, MO 63650-1406 | 2019-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497356919 | Cardinal Ritter Institute-resident Services Corp | Assisted Living Facility | 5890 Eichelberger St, Saint Louis, MO 63109-3454 | 2020-11-02 |
| 1831798214 | Smith Care Residential, LLC | Assisted Living Facility | 130 W Culton St, Warrensburg, MO 64093-1720 | 2020-10-18 |
| 1063010890 | Mitchell's Care Center LLC | Assisted Living Facility | 1134 W Norton Rd, Springfield, MO 65803-1070 | 2020-10-14 |
| 1982201935 | J & J Assisted Living LLC | Assisted Living Facility | 104 Wesbecher Ln, Marble Hill, MO 63764 | 2020-10-02 |
| 1144862350 | Humble Abode Residence | Assisted Living Facility | 18 S Duchesne Dr, Florissant, MO 63031-8112 | 2019-10-09 |
| 1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
| 1790343804 | Calvin Akins | Assisted Living Facility | 4432 W Belle Pl, Saint Louis, MO 63108-2617 | 2019-06-04 |
| 1245893296 | Michele Vinson Investments LLC Dba Bolivar Manor House | Assisted Living Facility | 404 E Broadway St, Bolivar, MO 65613-2019 | 2019-04-16 |
| 1073079091 | Homes That Care Co. | Assisted Living Facility | 4144 Lindell Blvd Ste 312, Saint Louis, MO 63108-2953 | 2019-02-14 |
| 1609387240 | Tammy Michelle Stone | Assisted Living Facility | 431 Ne County Road 10564, Adrian, MO 64720-5111 | 2017-10-23 |
| 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.