Bracken Homes

Primary specialty

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

License

8000161 Issued in MO

Legal business name

BRACKEN HOMES

Practice address

8108 Bel Ray Dr
Belton, MO 64012

Phone

(816) 507-8997

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By 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

Ms. Gail Lynne Rudolph

Title

Suprv QMRP

Phone

(816) 507-8997

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265654628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "64012",
            "telephone_number": "816-507-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8108 BEL RAY DR",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "64012",
            "telephone_number": "816-507-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRACKEN HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "SUPRV QMRP",
        "authorized_official_telephone_number": "816-507-8997",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "8000161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Bohnenstiehl
• William Xander Bolden
• Bone & Joint Specialists Physician Group, LLC
• Bone&Joint Specialist P.C.
• Erica Renee Bourbon, ANP-BC
• Douglas L Bradley, MD
• Nicole Brogan
• Elaine M. Broockerd, SPEECH PATHOLOGIST
• Christopher Brown
• Nicole Brown

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Belton, MO
• Providers in Belton, 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 Aug 22, 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.