NPIMap

Organization Active NPI

Centerville House

  • Developmentally Disabled Services Day Training Agency
  • Hannibal, MO
National Provider Identifier
1093930620
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
CENTERVILLE HOUSE
Practice address
7 Centerville Rd
Hannibal, MO 63401-6855
Phone
(573) 221-5222
NPI assigned
Apr 17, 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
Paul John Holtschlag
Title
President
Phone
(217) 228-9268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X MO Primary

Addresses

Primary practice location

7 Centerville Rd
Hannibal, MO 63401-6855

Mailing address

3325 Ghost Hollow Road
Quincy, IL 62305
Phone (217) 228-9268

National Provider Directory

National Provider Directory
Tax ID family
Personal Care Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093930620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 GHOST HOLLOW ROAD",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "62305",
            "telephone_number": "217-228-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CENTERVILLE RD",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016855",
            "telephone_number": "573-221-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLTSCHLAG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-228-9268"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, 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.