Mark Twain Assisted Living Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

036407 Issued in MO

Legal business name

MARK TWAIN ASSISTED LIVING INC.

Practice address

901 Union Ave
Moberly, MO 65270-2456

Phone

(660) 263-6515

Fax

(660) 263-0603

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kathryn L Miller

Title

Owner

Phone

(660) 263-6515

Specialties & licenses 1

Addresses

Other names 1

• Mark Twain of Huntsville Other name

Tax ID family

Mark Twain Assisted Living Inc2 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.

• Mark Twain Assisted Living Inc

  • Assisted Living Facility
  • Moberly, MO
  • NPI 1184798902
  NPD tax ID

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1457424590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E ELM ST",
            "city": "HUNTSVILLE",
            "state": "MO",
            "postal_code": "652591111",
            "telephone_number": "660-277-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652702456",
            "telephone_number": "660-263-6515",
            "fax_number": "660-263-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TWAIN ASSISTED LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-263-6515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MO",
            "license": "036407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark Twain of Huntsville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kenneth S Lorenz, MA, LMFT
• Tracie Crawford Lykins, PHARMD
• Prasanna Manjini Sengodan
• Kerri Manson
• Mark Twain Assisted Living Inc
• Vicky Lynn Martin, PLPC
• Sean Leonard Massa, PT
• Michael G Maurizi, MD
• Jason Anthony McClary, M.P.T
• Craig E McCoy, D.O.

• Assisted Living Facility (Mental Illness) in Moberly, MO
• Providers in Moberly, 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 May 6, 2010; 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.