J & J ASSISTIVE LIVING NPI 1194985739

NPI Information

NPI: 1194985739
Provider Name: J & J ASSISTIVE LIVING
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
104 WESBECHER
MARBLE, MO
ZIP 63764
Phone: (573) 238-1008
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J & J ASSISTIVE LIVING is a residential treatment facility, intellectual and/or developmental disabilities in Marble, MO. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. J & J ASSISTIVE LIVING NPI is 1194985739. The provider is registered as an organization entity type.

The provider's business location address is:

104 WESBECHER
MARBLE, MO
ZIP 63764
Phone: (573) 238-1008
Fax: (573) 238-3233

The provider's authorized official is Jon Charles Pierce .
The authorized official title is Administrator and has the following contact phone number (573) 238-4602.

The enumeration date for this NPI number is 6/16/2008 and was last updated on 6/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		034164	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	M268918505	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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