NPIMap

Organization Active NPI

Northwest Missouri Learning Center, Inc.

Doing business as Elm Street Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Tarkio, MO
National Provider Identifier
1073650123
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
MW01152 Issued in MO
Legal business name
NORTHWEST MISSOURI LEARNING CENTER, INC.
Doing business as
Elm Street Group Home
Practice address
704 Elm St
Tarkio, MO 64491-1629
Phone
(660) 736-5523
Fax
(660) 736-4884
NPI assigned
Jan 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joanna M. Trueblood
Title
Executive Director
Phone
(660) 736-5523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MW01152 MO Primary

Addresses

Primary practice location

704 Elm St
Tarkio, MO 64491-1629

Mailing address

302 Maple St
Tarkio, MO 64491-1342
Phone (660) 736-5523

Other names 1

  • Elm Street Group Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest Missouri Learning Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073650123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 MAPLE ST",
            "city": "TARKIO",
            "state": "MO",
            "postal_code": "644911342",
            "telephone_number": "660-736-5523",
            "fax_number": "660-736-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 ELM ST",
            "city": "TARKIO",
            "state": "MO",
            "postal_code": "644911629",
            "telephone_number": "660-736-5523",
            "fax_number": "660-736-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MISSOURI LEARNING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRUEBLOOD",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "660-736-5523"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "MW01152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm Street Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tarkio, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.