Life Christain Outreach

Primary specialty

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

Legal business name

LIFE CHRISTAIN OUTREACH

Practice address

3251 Pinetree Dr
Columbia, MO 65201-1706

Phone

(573) 875-1141

NPI assigned

Jan 7, 2013

Organization subpart

No

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

Authorized official

Name

Greg Ordway

Title

Vice President

Phone

(573) 256-6155

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Life Enterprises Doing business as

Tax ID family

Life Christain Outreach2 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.

• Life Christian Outreach

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Columbia, MO
  • NPI 1396885620
  NPD tax ID

Locations

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1508103896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N DOZIER STATION RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652027798",
            "telephone_number": "573-256-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 PINETREE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652011706",
            "telephone_number": "573-875-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHRISTAIN OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "ORDWAY",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "573-256-6155"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856254206",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Enterprises",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teniya Necole Lewis
• Jiang Li, MD
• Leyi Li, M.D.
• Ross Licklider, RN
• Michael Liebau, O.D.
• Life Christian Outreach
• Life Christian Outreach, Inc.
• Life Work Counseling, LLC
• Dennis L. Life, D.P.M.
• Lifepath of Mid-Missouri

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Columbia, MO
• Providers in Columbia, 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 Jan 8, 2013; 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.