Wilcox Properties of Columbia LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

034174 Issued in MO

Legal business name

WILCOX PROPERTIES OF COLUMBIA LLC

Doing business as

Candlelight Lodge

Practice address

1406 Business Loop 70 W
Columbia, MO 65202-1324

Phone

(573) 449-5284

NPI assigned

Sep 13, 2007

Organization subpart

No

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

Authorized official

Name

Eric L Clark

Title

Business Manager

Phone

(573) 449-5287

Specialties & licenses 1

Addresses

Other names 1

• Candlelight Lodge Doing business as

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1164617064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 BUSINESS LOOP 70 W",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021324",
            "telephone_number": "573-449-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 BUSINESS LOOP 70 W",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021324",
            "telephone_number": "573-449-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILCOX PROPERTIES OF COLUMBIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "573-449-5287"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "034174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Candlelight Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Edward Wienke, R.PH., CGP
• Natalie Brooke Wier, RDMS, RVT
• Sebastian David Wiesemann, M.D.
• Ashlee Wiessing, M.A., CCC-SLP
• Sara Wiggins, ANP-BC
• Kirk Lewis Wilcox, MD
• Grace E Wildenhaus, MSW, LCSW
• Mark F Wildman, PA-C
• Brandon Michael Wiler, DPT, ATC
• Cara Wilfong, DC

• Assisted Living Facility in Columbia, MO
• Providers in Columbia, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.