NPIMap

Organization Active NPI

Nodaway County Services for the Developmentally Disabled, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Maryville, MO
National Provider Identifier
1215080726
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
5473-7088 Issued in MO
Legal business name
NODAWAY COUNTY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.
Practice address
122 East Lieber Street
Maryville, MO 64468-0454
Phone
(660) 582-7113
Fax
(660) 582-3493
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Ms. Mary Elizabeth Carrick
Title
Executive Director
Phone
(660) 582-7113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 5473-7088 MO Primary

Addresses

Primary practice location

122 East Lieber Street
Maryville, MO 64468-0454

Mailing address

122 East Lieber Street
P. O. Box 454
Maryville, MO 64468-0454
Phone (660) 582-7113

National Provider Directory

National Provider Directory
Tax ID family
Nodaway County Services for the Developmentally Disabled Inc2 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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1215080726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 EAST LIEBER STREET",
            "address_2": "P. O. BOX 454",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644680454",
            "telephone_number": "660-582-7113",
            "fax_number": "660-582-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 EAST LIEBER STREET",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644680454",
            "telephone_number": "660-582-7113",
            "fax_number": "660-582-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NODAWAY COUNTY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "CARRICK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "16605827113",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "5473-7088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.