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MAPLE RIDGE RESIDENTIAL CARE LLC NPI 1992822639


NPI Information

NPI: 1992822639
Provider Name: MAPLE RIDGE RESIDENTIAL CARE LLC
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

CLIA Number: 26D0924309

Address:
1034 DORIS DR
FARMINGTON, MO
ZIP 63640
Phone: (573) 760-0155
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MAPLE RIDGE RESIDENTIAL CARE LLC is an assisted living and mental illness assisted living facility in Farmington, MO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. MAPLE RIDGE RESIDENTIAL CARE LLC NPI is 1992822639. The provider is registered as an organization entity type.

The provider's business location address is:

1034 DORIS DR
FARMINGTON, MO
ZIP 63640-954
Phone: (573) 760-0155
Fax: (573) 760-0524

The provider's authorized official is Patricia Anderson .
The authorized official title is Secretary and has the following contact phone number (573) 546-1616.

The CLIA number assigned to this NPI record is 26D0924309 - other - residential care facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/26/2007 and was last updated on 8/22/2020.


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
13104A0625XAssisted Living FacilityAssisted Living, Mental Illness033512MISSOURIYes

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

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