Cass-Way, LLC

Primary specialty

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

License

210-336-76 Issued in MO

Legal business name

CASS-WAY, LLC

Practice address

17512 S Reynolds Rd
Pleasant Hill, MO 64080-9342

Phone

(816) 803-5153

Fax

(816) 817-0612

NPI assigned

Dec 8, 2016

Last updated

Dec 8, 2016By 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

Michael Matukewicz

Title

Owner/Professional Manager

Phone

(816) 716-6135

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• J & L Farm, LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Michael Gassaway, PSYCHOLOGIST

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Pleasant Hill, MO
  • NPI 1619208139

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past)

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1467996520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17512 S REYNOLDS RD",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "64080",
            "telephone_number": "816-803-5153",
            "fax_number": "816-817-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17512 S REYNOLDS RD",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640809342",
            "telephone_number": "816-803-5153",
            "fax_number": "816-817-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASS-WAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "MATUKEWICZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PROFESSIONAL MANAGER",
        "authorized_official_telephone_number": "816-716-6135"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "210-336-76",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WC1-0364-1011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J & L Farm, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• James Cannon, FNP-BC
• Victoria Elizabeth Caskey
• Cass Regional Medical Center (Pleasant Hill Imaging Center)
• Cass Regional Medical Center (Pleasant Hill Medical Clinic)
• Cass Regional Medical Center (Pleasant Hill Medical Center)
• Eric Christensen, R.PH.
• Brian Edward Compton, DO
• Cosentino Enterprises Inc (Price Chopper Pharmacy)
• Brooke Erin Crotty, RDN
• Raymond Ross Dale Jr.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pleasant Hill, MO
• Providers in Pleasant Hill, 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 Dec 8, 2016; 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.