RANDOLPH COUNTY DEVELOPMENTAL DISABILITY SERVICES NPI 1982978169

NPI Information

  • NPI: 1982978169
  • Provider Name: RANDOLPH COUNTY DEVELOPMENTAL DISABILITY SERVICES
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 101 W COATES ST
    MOBERLY, MO
    ZIP 65270
  • Phone: (660) 269-8875

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NPI Details

RANDOLPH COUNTY DEVELOPMENTAL DISABILITY SERVICES is a community based residential treatment facility, intellectual and/or developmental disabilities in Moberly, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. RANDOLPH COUNTY DEVELOPMENTAL DISABILITY SERVICES NPI is 1982978169. The provider is registered as an organization entity type.

The provider's business location address is:

101 W COATES ST
MOBERLY, MO
ZIP 65270-521
Phone: (660) 269-8875
Fax: (660) 269-9621

The provider's authorized official is Mindy Beth Breid .
The authorized official title is Director Of Administration and has the following contact phone number (660) 269-8875.

The enumeration date for this NPI number is 3/6/2012 and was last updated on 9/4/2012.

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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

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
1159041201MEDICAIDMISSOURI

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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