Northwest Missouri Supportive Services

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

NORTHWEST MISSOURI SUPPORTIVE SERVICES

Practice address

308 South Prospect
Stanberry, MO 64489-0222

Phone

(660) 783-2464

NPI assigned

Mar 6, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martin Dale Weatherd

Title

Executive Manager

Phone

(816) 827-1254

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093844722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "address_2": "401 SOUTH STANBERRY STREET",
            "city": "STANBERRY",
            "state": "MO",
            "postal_code": "644890222",
            "telephone_number": "660-783-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 SOUTH PROSPECT",
            "city": "STANBERRY",
            "state": "MO",
            "postal_code": "644890222",
            "telephone_number": "660-783-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MISSOURI SUPPORTIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEATHERD",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "816-827-1254"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Trails, LLC 9TH Street
• New Trails, LLC College St.
• New Trails, LLC Stanberry
• Northwest Health Services Inc (Stanberry R-II School District)
• Northwest Medical Center Association, Inc (Mosaic Family Care Stanberry)
• Pine View Manor, Inc.
• Pine View Manor, Inc.
• Spec Shoppe II
• Stanberry Independent Living
• Stanberry R-II School

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Stanberry, MO
• Providers in Stanberry, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• 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.