McWilliams Manor, Incorporated

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

8001561 Issued in MO

Legal business name

MCWILLIAMS MANOR, INCORPORATED

Practice address

3439 S Westwood Blvd
Poplar Bluff, MO 63901-8670

Phone

(573) 727-9760

Fax

(573) 727-9760

NPI assigned

Mar 14, 2007

Organization subpart

Yes

Parent organization

MCWILLIAMS MANOR, INCORPORATEDAs reported in NPPES

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

Authorized official

Name

Mrs. Patricia L Westover-McWilliams, MRN

Title

Owner

Phone

(573) 727-9760

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dba McWilliams Manor ISL Doing business as

Tax ID family

McWilliams Manor Incorporated2 organizations share this tax ID, including this one

Part of

McWilliams Manor Incorporated

Other organizations with this tax ID 1

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

• McWilliams Manor, Incorporated

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Poplar Bluff, MO
  • NPI 1467570085
  NPD tax ID

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1699808766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 S WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018670",
            "telephone_number": "573-727-9760",
            "fax_number": "573-727-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3439 S WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018670",
            "telephone_number": "573-727-9760",
            "fax_number": "573-727-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCWILLIAMS MANOR, INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCWILLIAMS MANOR, INCORPORATED",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "WESTOVER-MCWILLIAMS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-727-9760",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MRN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "8001561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "858524713",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba McWilliams Manor ISL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peyton Jane McNeal, SLP
• Paige A McNew
• Kenneth B McVey, DO
• Lindsay R McVey, FNP
• McWilliams Manor, Incorporated
• Med-Trans Corporation
• Ashlee Medler
• Kayla S Melton, O.D.
• Mercy Pharmacy Services, LLC
• Robert Gene Merriott Jr.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.