Organization Active NPI

Jefferson City Residential, LLC

  • Alzheimer Center (Dementia Center)
  • Jefferson City, MO
National Provider Identifier
1164792917
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
Legal business name
JEFFERSON CITY RESIDENTIAL, LLC
Doing business as
The Arbors at Westbrook Terrace
Westbrook Terrace Memory Care I
Practice address
3409 N Ten Mile Dr
Jefferson City, MO 65109-0530
Phone
(573) 471-1113
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Kyle Timothy Schade
Title
Manager
Phone
(573) 471-1113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X Primary

Addresses

Primary practice location

3409 N Ten Mile Dr
Jefferson City, MO 65109-0530

Mailing address

3409 N Ten Mile Dr
Jefferson City, MO 65109-0530

Other names 2

  • The Arbors at Westbrook Terrace Doing business as
  • Westbrook Terrace Memory Care I Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2035287Westbrook Terrace Memory Care 13409 North Ten Mile Drive, Jefferson City, MO 65109Certificate of waiverJan 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Jefferson City Residential LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1164792917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 N TEN MILE DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N TEN MILE DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090530",
            "telephone_number": "573-471-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON CITY RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "SCHADE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-471-1113"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Arbors at Westbrook Terrace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Arbors at Westbrook Terrace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westbrook Terrace Memory Care I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.