MEDICALODGES INC. NPI 1316017544

NPI Information

  • NPI: 1316017544
  • Provider Name: MEDICALODGES, INC.
  • Classification: Clinic/Center - 261QA0600X
  • Specialization: Adult Day Care
  • Entity Type: Organization
  • Doing Business As: GRAN VILLAS NEOSHO
  • CLIA Number: 26D0955662
  • Address: 420 W LYON DR
    NEOSHO, MO
    ZIP 64850
  • Phone: (417) 451-7071

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NPI Details

MEDICALODGES, INC. is an adult day care clinic center in Neosho, MO. MEDICALODGES, INC. NPI is 1316017544. The provider is registered as an organization entity type.
The provider Is Doing Business As Gran Villas Neosho.

The provider's business location address is:

420 W LYON DR
NEOSHO, MO
ZIP 64850-194
Phone: (417) 451-7071
Fax: (417) 451-5127

The provider's authorized official is Cathy W Fisher .
The authorized official title is Chief Financial Officer and has the following contact phone number (620) 251-6700.

The CLIA number assigned to this NPI record is 26D0955662 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 4/19/2011.

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
1251E00000XHome Health031639MISSOURINo
2261QA0600XClinic/CenterAdult Day Care031639MISSOURIYes

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
1268025509MEDICAIDMISSOURI
2031639MEDICAIDMISSOURI

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: 11/21/2025

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