Callaway County Special Servfices

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CALLAWAY COUNTY SPECIAL SERVFICES

Practice address

226 Maple St
New Bloomfield, MO 65063-1594

Phone

(573) 491-3858

NPI assigned

Mar 9, 2007

Organization subpart

Yes

Parent organization

CALLAWAY COUNTY SPECIAL SERVICESAs reported in NPPES

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

Authorized official

Name

Mr. Charles Snow

Title

Executive Director

Phone

(573) 642-1792

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Timbrook House Doing business as

Tax ID family

Callaway County Special Services3 organizations share this tax ID, including this one

Part of

Callaway County Special Services

Other organizations with this tax ID 2

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

• Callaway County Special Services

  • Developmentally Disabled Services Day Training Agency
  • Fulton, MO
  • NPI 1801928775
  NPD tax ID
• Callaway County Special Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fulton, MO
  • NPI 1992932354
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Callaway County Special Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fulton, MO
  • NPI 1992932354
  NPPES parent name

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1104958040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 S BUSINESS 54",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511406",
            "telephone_number": "573-642-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MAPLE ST",
            "city": "NEW BLOOMFIELD",
            "state": "MO",
            "postal_code": "650631594",
            "telephone_number": "573-491-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLAWAY COUNTY SPECIAL SERVFICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALLAWAY COUNTY SPECIAL SERVICES",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-642-1792",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853013803",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timbrook House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Callaway County R-111 School
• Teresa A Campbell
• Kimberly Chitwood, D.C.
• Doug Howard
• Trina Anne Hudson, LPC
• Lester E Cox Medical Centers

• All providers in New Bloomfield, MO
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.