NPIMap

Organization Active NPI

Lakeshores Residential Care Facility

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Urbana, MO
National Provider Identifier
1215055371
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
LAKESHORES RESIDENTIAL CARE FACILITY
Practice address
27 Hopper TRL
Urbana, MO 65767-9234
Phone
(417) 722-4416
Fax
(417) 722-4417
NPI assigned
Mar 27, 2007
Last updated
Jun 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Miss Sandra Rutherford
Title
Manager
Phone
(417) 722-4416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

27 Hopper TRL
Urbana, MO 65767-9234

Mailing address

PO Box 385
Preston, MO 65732-0385
Phone (417) 722-4166

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1215055371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 385",
            "city": "PRESTON",
            "state": "MO",
            "postal_code": "657320385",
            "telephone_number": "417-722-4166",
            "fax_number": "417-722-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORES RESIDENTIAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "RUTHERFORD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "417-722-4416",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.