RAVENWOOD RESIDENTIAL, LLC (NPI# 1992751283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992751283 |
| Entity Type | Organization |
| Organization Name | RAVENWOOD RESIDENTIAL, LLC |
| Other Organization Name | RAVENWOOD ASSISTED LIVING |
| Practice Address |
1950 E Republic Rd Springfield MO 65804-6763 |
| Practice Telephone | 4178906000 |
| Mailing Telephone | 4178906000 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES REIKER (TREASURER) |
| Authorized Official Telephone | 5734711113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Ravenwood Assisted Living | Doing Business As Name - Organization |
| Street Address |
1950 E REPUBLIC RD |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-6763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871107482 | Springfield Residential, LLC | Assisted Living Facility | 2530 South Main Street, Springfield, TN 37172 | 2020-09-01 |
| 1649835034 | Joyco, Inc. | Assisted Living Facility | 2030 W Mount Vernon St, Springfield, MO 65802-4846 | 2019-05-01 |
| 1033648274 | Creekside At Elfindale | Assisted Living Facility | 1601 S Fort Ave, Springfield, MO 65807-8430 | 2017-06-10 |
| 1386039659 | Snh Al Aimo Tenant, Inc. | Assisted Living Facility | 3540 E Cherokee St, Springfield, MO 65809-2833 | 2015-04-02 |
| 1023403391 | Snh Al Aimo Tenant, Inc. | Assisted Living Facility | 2410 W Chesterfield Blvd, Springfield, MO 65807-8889 | 2015-04-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1851793285 | Timberlake Estates Slf, Lp | Assisted Living Facility | 2521 Empowerment Rd, Springfield, IL 62703-4983 | 2014-09-17 |
| 1851664981 | Sunrise Springfield Assisted Living LLC | Assisted Living Facility | 6541 Franconia Rd, Springfield, VA 22150-1801 | 2012-02-21 |
| 1215209226 | Bslc II | Assisted Living Facility | 1302 West Sunset, Springfield, MO 65807-5943 | 2012-02-07 |
| 1497998918 | Timberlake Senior Living | Assisted Living Facility | 2521 Empowerment Road, Springfield, IL 62703 | 2009-04-14 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.