Kybama, Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

KYBAMA, INC

Doing business as

The Legacy Ranch

Practice address

12729 Stoney Point Rd
Bonne Terre, MO 63628-5500

Phone

(573) 631-2897

Fax

(573) 358-8727

NPI assigned

Dec 12, 2022

Last updated

Dec 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lennie Michael Fincher

Title

President

Phone

(573) 631-2897

Specialties & licenses 1

Addresses

Other names 1

• The Legacy Ranch Doing business as

Electronic endpoints 1

Tax ID family

Kybama Inc2 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.

• Kybama, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bonne Terre, MO
  • NPI 1437675477
  NPD tax ID

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1699486506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636640071",
            "telephone_number": "573-358-8703",
            "fax_number": "573-358-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12729 STONEY POINT RD",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636285500",
            "telephone_number": "573-631-2897",
            "fax_number": "573-358-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYBAMA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "FINCHER",
        "authorized_official_first_name": "LENNIE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-631-2897"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "nfincher.tlr@gmail.com",
            "affiliation": "N",
            "address_1": "17770 Saddle Creek Dr",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636403568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Legacy Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meggan Jones
• Andrea Kahn, MS CCC-SLP
• Kingdom United Education Incorporated (Kingdom Health)
• Pamela Sue Kiser, M.A.,CCC-SLP
• Kybama, Inc
• Laura Lahay
• John Paul Lawson Jr., PHARM.D.
• Lauren Emily Lewis, MA
• Theresa L Lumos, LPC
• Taylor Michael Lumsden, MPT

• Professional Counselor in Bonne Terre, MO
• Providers in Bonne Terre, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.