NPIMap

Organization Active NPI

Beth Haven Group Homes Inc

  • Adult Care Home Facility
  • Hannibal, MO
National Provider Identifier
1629128970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
BETH HAVEN GROUP HOMES INC
Practice address
2518 Pleasant St
Hannibal, MO 63401-2659
Phone
(573) 221-2258
NPI assigned
Jan 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Paul Ewert
Title
Chief Executive Officer
Phone
(573) 221-2258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

2518 Pleasant St
Hannibal, MO 63401-2659

Mailing address

2500 Pleasant St
Hannibal, MO 63401-2600
Phone (573) 221-2258

Other names 1

  • Magnolia Other name

National Provider Directory

National Provider Directory
Tax ID family
Beth Haven Group Homes Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2518 Pleasant St
Hannibal, MO 63401
Phone (573) 221-2258

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629128970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 PLEASANT ST",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012600",
            "telephone_number": "573-221-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 PLEASANT ST",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012659",
            "telephone_number": "573-221-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH HAVEN GROUP HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EWERT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "573-221-2258",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.