NPIMap

Organization Active NPI

Willows Way, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Saint Charles, MO
National Provider Identifier
1225364987
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
WILLOWS WAY, INC
Practice address
800 Friedens Rd Ste 100
Saint Charles, MO 63303-4234
Phone
(636) 947-6591
Fax
(636) 947-8532
NPI assigned
Oct 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Authorized official

Name
Mr. Steven Brennell
Title
Executive Director
Phone
(636) 947-6591

Specialties & licenses 1

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

Addresses

Primary practice location

800 Friedens Rd Ste 100
Saint Charles, MO 63303-4234

Mailing address

800 Friedens Rd Ste 100
Saint Charles, MO 63303-4234
Phone (636) 947-6591

Other identifiers 3

IdentifierTypeStateIssuer
268886504MedicaidMO
852962604MedicaidMO
288886500MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Willows Way Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1225364987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FRIEDENS RD STE 100",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034234",
            "telephone_number": "636-947-6591",
            "fax_number": "636-947-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FRIEDENS RD STE 100",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034234",
            "telephone_number": "636-947-6591",
            "fax_number": "636-947-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWS WAY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "BRENNELL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "636-947-6591",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268886504",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852962604",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288886500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.