Brookside Casa

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BROOKSIDE CASA

Practice address

17858 Brookside Rd
Barnett, MO 65011-3023

Phone

(573) 378-2266

Fax

(573) 378-2267

NPI assigned

Mar 28, 2007

Last updated

Jul 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Densie L Spotila

Title

Administrator

Phone

(573) 378-2266

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1215056437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17858 BROOKSIDE RD",
            "city": "BARNETT",
            "state": "MO",
            "postal_code": "650113023",
            "telephone_number": "573-378-2266",
            "fax_number": "573-378-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17858 BROOKSIDE RD",
            "city": "BARNETT",
            "state": "MO",
            "postal_code": "650113023",
            "telephone_number": "573-378-2266",
            "fax_number": "573-378-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE CASA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "SPOTILA",
        "authorized_official_first_name": "DENSIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-378-2266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856254107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steffanie Anne Boettcher, MIDWIFE
• Nicholas Knaup, DC
• Mid-Mo House Calls, LLC
• Marlene G Sauder, CPM

• Community/Behavioral Health Agency in Barnett, MO
• Providers in Barnett, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.