Maple Ridge Residential Care Center, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

MAPLE RIDGE RESIDENTIAL CARE CENTER, LLC

Practice address

1034 Doris Dr
Farmington, MO 63640-1954

Phone

(573) 330-3760

NPI assigned

Apr 23, 2018

Organization subpart

No

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

Authorized official

Name

Karen Eileen Veach

Title

Owner

Phone

(573) 330-3760

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1407343791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636400272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 DORIS DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401954",
            "telephone_number": "573-330-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE RIDGE RESIDENTIAL CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "VEACH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-330-3760"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Lumma, M.A., CF-SLP
• Bob Hollis Lype, O.D.
• Connie Marie Macbride, MA, LPC, NCC
• Tereesa Mahoney
• Ghulam Makhdoom, DDS
• Maple Ridge Residential Care LLC
• Marissa Phegley LPC LLC
• Hannah Jane Marler
• Brian Martin, DPM
• Jockese Martin, A.S.S.

• Assisted Living Facility (Mental Illness) in Farmington, MO
• Providers in Farmington, MO by specialty
• Assisted Living Facility (Mental Illness) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.