Making a Difference Treatment Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

MAKING A DIFFERENCE TREATMENT INC

Practice address

844 Hwy 32
Bolivar, MO 65613-8213

Phone

(417) 422-4702

Fax

(417) 422-4730

NPI assigned

May 6, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Craig Stephen Edwards, ED.S

Title

Administrator

Phone

(417) 422-4702

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1629825641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 HWY 32",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138213",
            "telephone_number": "417-422-4702",
            "fax_number": "417-422-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 HWY 32",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138213",
            "telephone_number": "417-422-4702",
            "fax_number": "417-422-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKING A DIFFERENCE TREATMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "417-422-4702",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED.S"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy M Lueckenhoff, SLP
• Krista Lutz, CD, CBE, CLC
• Joshua L Macken, PA-C
• Julia Magdici, FNP-C
• Thomas William Maggard, DPT
• Cassie Lyn Maness, PHARM D
• Kevin Wayne Marcum, LPC
• Linda M Marshall, PT
• Steven T. Marshall, D.D.S
• Jaime Marsolf, PHARM.D

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.