Advance Missouri Health Care

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

040505 Issued in MO

Legal business name

ADVANCE MISSOURI HEALTH CARE

Doing business as

Advance Assisted Living

Practice address

20104 State Highway O
Advance, MO 63730-0790

Phone

(573) 722-5200

Fax

(573) 722-3239

NPI assigned

Sep 25, 2012

Last updated

Sep 25, 2012By 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

Mr. Jeffrey Edward Newman

Title

LLC Member

Phone

(573) 686-5242

Specialties & licenses 1

Addresses

Other names 1

• Advance Assisted Living Doing business as

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1336490820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 790",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "637300790",
            "telephone_number": "573-722-5200",
            "fax_number": "573-722-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20104 STATE HIGHWAY O",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "637300790",
            "telephone_number": "573-722-5200",
            "fax_number": "573-722-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MISSOURI HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "573-686-5242",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "040505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Advance Medical Clinic
• Advance R-IV Public Schools
• Aspire Senior Living Advance, LLC (Aspire Senior Living Advance)
• John Backfisch, LPC
• Kimberly Backfisch, LPC, RPT
• Cindy Beussink, M.A.,CCC-SLP

• Assisted Living Facility in Advance, MO
• Providers in Advance, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.