BAREFOOTBOY LLC NPI 1790940989

NPI Information

  • NPI: 1790940989
  • Provider Name: BAREFOOTBOY LLC
  • Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
  • Entity Type: Organization
  • Doing Business As: OAKBROOK RESIDENCE
  • Address: 723 S SCENIC AVE
    723 S.SCENIC
    SPRINGFIELD, MO
    ZIP 65802
  • Phone: (417) 864-6200

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NPI Details

BAREFOOTBOY LLC is a residential treatment facility physical disabilities in Springfield, MO. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. BAREFOOTBOY LLC NPI is 1790940989. The provider is registered as an organization entity type.
The provider Is Doing Business As Oakbrook Residence.

The provider's business location address is:

723 S SCENIC AVE
723 S.SCENIC
SPRINGFIELD, MO
ZIP 65802-042
Phone: (417) 864-6200
Fax: (417) 864-4413

The provider's authorized official is Rajab Tongwa Echessa .
The authorized official title is Administrator and has the following contact phone number (417) 207-1680.

The enumeration date for this NPI number is 7/28/2008 and was last updated on 7/28/2008.

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
1320700000XResidential Treatment Facility, Physical Disabilities035394MISSOURIYes

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
1266758408MEDICAIDMISSOURI

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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