Life Enhancement Village

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

032542 Issued in MO

Legal business name

LIFE ENHANCEMENT VILLAGE

Practice address

732 S Gregg Rd
Nixa, MO 65714-7419

Phone

(417) 725-6671

Fax

(417) 725-6671

NPI assigned

Feb 22, 2008

Organization subpart

No

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

Authorized official

Name

Kenny L Rogers

Title

Ceo

Phone

(417) 725-6680

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Life Enhancement Village3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Life Enhancement Village of Branson

  • Assisted Living Facility (Mental Illness)
  • Walnut Shade, MO
  • NPI 1689842916
  NPD tax ID
• Life Enhancement Village of the Ozarks, Inc.

  • Assisted Living Facility (Mental Illness)
  • Nixa, MO
  • NPI 1841474871
  NPD tax ID

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1538338652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 S GREGG RD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147419",
            "telephone_number": "417-725-6671",
            "fax_number": "417-725-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 S GREGG RD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147419",
            "telephone_number": "417-725-6671",
            "fax_number": "417-725-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ENHANCEMENT VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-725-6680"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MO",
            "license": "032542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3751109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lester E Cox Medical Centers (CoxHealth Urgent Care Nixa)
• Holly K Letterman-Hitt, FNP-BC
• Grace Susan Levering
• Cece Lewis
• Life Chiropractic Clinic LLC
• Life Enhancement Village of the Ozarks, Inc.
• Life Enhancement Village Operating Company LLC
• Life Expressions Chiropractic
• Life Solutions, LLC
• Makayla Sky Light

• Assisted Living Facility (Mental Illness) in Nixa, MO
• Providers in Nixa, 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 Feb 22, 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.