NPIMap

Organization Active NPI

Applewood Group Home

  • Mental Illness Intermediate Care Facility
  • Lebanon, MO
National Provider Identifier
1194840702
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
Legal business name
APPLEWOOD GROUP HOME
Practice address
18811 Highway 32
Lebanon, MO 65536-8102
Phone
(417) 532-2774
Fax
(417) 722-4417
NPI assigned
Mar 20, 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
Mr. Gary D Boggs
Title
President
Phone
(417) 722-4416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X NU Primary

Addresses

Primary practice location

18811 Highway 32
Lebanon, MO 65536-8102

Mailing address

27 Hopper TRL
Urbana, MO 65767-9234
Phone (417) 722-4416

National Provider Directory

National Provider Directory
Tax ID family
Applewood Group Home9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194840702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 HOPPER TRL",
            "city": "URBANA",
            "state": "MO",
            "postal_code": "657679234",
            "telephone_number": "417-722-4416",
            "fax_number": "417-722-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18811 HIGHWAY 32",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655368102",
            "telephone_number": "417-532-2774",
            "fax_number": "417-722-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEWOOD GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-722-4416",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, 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.