Lasting Impressions Group Home

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

LASTING IMPRESSIONS GROUP HOME

Practice address

308 E Smith St
Smithton, MO 65350-1079

Phone

(660) 343-3681

Fax

(660) 343-5871

NPI assigned

May 23, 2007

Last updated

Oct 7, 2014By 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

Shannon Dee WassamNPI 1356465033

Title

Director

Phone

(660) 343-3681

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Dee Wassam

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Smithton, MO
  • NPI 1356465033

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past) Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1235349614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513",
            "city": "SMITHTON",
            "state": "MO",
            "postal_code": "653500513",
            "telephone_number": "660-343-3681",
            "fax_number": "660-343-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E SMITH ST",
            "city": "SMITHTON",
            "state": "MO",
            "postal_code": "653501079",
            "telephone_number": "660-343-3681",
            "fax_number": "660-343-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASTING IMPRESSIONS GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "WASSAM",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "660-343-3681"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawna Fisher, BSN, RN, CNOR, RNFA
• Carolyn Gifford
• Jason Kindle, PT
• Ronald J Hicken (Parkview Group Home)
• Sandra Ross, COTA/L
• School District R 6 Smithton (Smithton R-VI)
• Melissa Walsh, M.S., CCC-SLP
• Shannon Dee Wassam

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Smithton, MO
• Providers in Smithton, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.