PRC Enterprises

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

14078480 Issued in MO

Legal business name

PRC ENTERPRISES

Practice address

650 Vine St
Poplar Bluff, MO 63901-5039

Phone

(573) 778-1126

Fax

(573) 785-4887

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Patricia Rose Campbell

Title

Owner

Phone

(573) 778-1126

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• A1care Doing business as

Tax ID family

A1Care2 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.

• PRC Enterprises, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Poplar Bluff, MO
  • NPI 1982804324
  NPD tax ID

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1508925025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 VINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015039",
            "telephone_number": "573-778-1126",
            "fax_number": "573-785-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 VINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015039",
            "telephone_number": "573-778-1126",
            "fax_number": "573-785-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRC ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-778-1126",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MO",
            "license": "14078480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193400000X",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A1care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rochelle Poynor, RRT
• Myesha Prater
• Carol Lee Pratt, FNP-BC
• Sandra Joy Pratt, PHARMD
• Stephanie Pratt
• PRC Enterprises, Inc.
• Preferred Family Health Care & Aesthetics, LLC
• Preferred Family Healthcare
• Preferred Family Healthcare
• Preferred Family Healthcare

• Intellectual & Developmental Disabilities Psychologist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Intellectual & Developmental Disabilities Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.