Wyatt'S Dream Center, LLC

Primary specialty

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

Legal business name

WYATT'S DREAM CENTER, LLC

Doing business as

WYATT'S DREAM CENTER

Practice address

205 State Highway Aa
Sikeston, MO 63801-5303

Phone

(573) 475-8025

Fax

(573) 475-8026

NPI assigned

Nov 7, 2019

Organization subpart

No

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

Authorized official

Name

Melissa A Stewart

Title

Owner/Administrator

Phone

(573) 380-8035

Specialties & licenses 1

Addresses

Other names 2

• WYATT'S DREAM CENTER Doing business as
• Wyatt's Dream Center, LLC Former legal business name

Tax ID family

Wyatt'S Dream Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wyatt'S Dream Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Sikeston, MO
  • NPI 1942851399
  NPD tax ID

Locations

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1427693092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 DACUS DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019013",
            "telephone_number": "573-380-8035",
            "fax_number": "573-475-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 STATE HIGHWAY AA",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015303",
            "telephone_number": "573-475-8025",
            "fax_number": "573-475-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT'S DREAM CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "573-380-8035"
    },
    "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": [
        {
            "organization_name": "WYATT'S DREAM CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wyatt's Dream Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kali Wingerter
• Robert P. Wissore, LPC
• Madeline June Witt, COTA/L
• Lashea Worley, MA, CCC-SLP
• Wyatt'S Dream Center
• Shannon Elizabeth Wylie, OTR/L
• Christy Rojana Wyman, LCSW
• Hannah Yant, RDN, LDN
• Emily Camille Young
• Lacey Rose Young, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Sikeston, MO
• Providers in Sikeston, 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 Nov 7, 2019; 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.