Lisa Renee Bain

Individual provider Active NPI Adult Day Care Clinic/Center · Clinton, MO

NPI 1477955409 · NPPES record last updated Sep 22, 2014

Key facts

NPI
1477955409
Entity type
Individual (NPI type 1)
Primary specialty
Adult Day Care Clinic/Center 261QA0600X
Practice address
905 N Price LN
Clinton, MO 64735-1721
Phone
(660) 885-1095
Fax
(660) 885-1095
NPI assigned
Sep 22, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mom and Pop'S Adult Care Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Yes

Addresses

Primary practice location

905 N Price LN
Clinton, MO 64735-1721

Mailing address

905 N Price LN
Clinton, MO 64735-1721
Phone (660) 885-1095

Other providers in Clinton, MO

All providers in Clinton, MO · Adult Day Care Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.