Goggin Boarding Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOGGIN BOARDING HOME, LLC

Practice address

620 Country Road 40
Caledonia, MO 63631

Phone

(573) 697-5894

Fax

(573) 697-5894

NPI assigned

Mar 9, 2020

Organization subpart

No

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

Authorized official

Name

Connie Goggin

Title

Administrator

Phone

(573) 697-5894

Specialties & licenses 2

Addresses

Other names 1

• Goggin Boarding Home Former legal business name

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1083249155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 COUNTRY ROAD 40",
            "city": "CALEDONIA",
            "state": "MO",
            "postal_code": "63631",
            "telephone_number": "573-697-5894",
            "fax_number": "573-697-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 COUNTRY ROAD 40",
            "city": "CALEDONIA",
            "state": "MO",
            "postal_code": "63631",
            "telephone_number": "573-697-5894",
            "fax_number": "573-697-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOGGIN BOARDING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "GOGGIN",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-697-5894"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goggin Boarding Home",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Valley R-VI School District
• Janet Lynn Woods, M.A.,CCC-SLP

• All providers in Caledonia, MO
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.