Pony Bird Incorporated
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Mapaville, MO
NPI 1396865713 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1396865713
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- License
- 1351-8421 (MO)
- Legal business name
- PONY BIRD INCORPORATED
- Practice address
- #1 Pony Bird Lane
Mapaville, MO 63065-0190 - Phone
- (636) 931-5818
- Fax
- (636) 931-3518
- NPI assigned
- Mar 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Linda M Dallas, BSN, MAHSM
- Title
- Executive Director
- Phone
- (636) 931-5818
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Pony Bird Incorporated
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | 1351-8421 | MO | Yes |
Addresses
Primary practice location
#1 Pony Bird Lane
Mapaville, MO 63065-0190
Mailing address
PO Box 190
Mapaville, MO 63065-0190
Phone (636) 931-5818
Other providers in Mapaville, MO
- Mary Jane King
- Nancy Lynn Menke
- Lauryn E Morris
- Nextstep for Life, Inc.
- Pony Bird Incorporated
- Pony Bird Incorporated
- Pony Bird Incorporated
- St Elizabeth Adult Day Care Center, Inc.
All providers in Mapaville, MO · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.